Effect of single-dose methotrexate on ovarian reserve in women with ectopic pregnancy

Uyar, İbrahim; Yucel, Onur Umut; Gezer, Cenk; Gülhan, İbrahim; Karis, Buket; Hanhan, H. Merih; Özeren, Mehmet

doi:10.1016/j.fertnstert.2013.06.040

Cited by 27 publications

(34 citation statements)

References 17 publications

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“…Two studies by the same author were published as abstracts only and were therefore excluded [14]. One additional study was excluded because none of the patients were undergoing ART [15]. Seven studies met all the inclusion criteria [16][17][18][19][20][21][22].…”

Section: Systematic Reviewmentioning

confidence: 99%

Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes

Boots¹,

Hill²,

Feinberg

et al. 2016

J Assist Reprod Genet

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Purpose The purpose of this research was to study whether methotrexate (MTX) as treatment for ectopic pregnancy (EP) impacts the future fertility of women undergoing assisted reproductive technology (ART) Methods In a systematic review and multi-center retrospective cohort from four academic and private fertility centers, 214 women underwent an ART cycle before and after receiving MTX as treatment for an EP. Measures of ovarian reserve and responsiveness and rates of clinical pregnancy (CP) and live birth (LB) were compared in the ART cycles prior and subsequent to MTX. Results Seven studies were identified in the systematic review, and primary data from four institutions was included in the final analysis. Women were significantly older in post-MTX cycles (35.3 vs 34.7 years). There were no differences in follicle stimulating hormone, antral follicle count, duration of stimulation, oocytes retrieved, or fertilization rate between pre-and post-MTX cycles. However, post-MTX cycles received a significantly higher total dose of gonadotropins (4206 vs 3961 IU). Overall, 42 % of women achieved a CP and 35 % achieved a LB in the post-MTX ART cycle, which is similar to national statistics. Although no factors were identified that were predictive of LB in young women, the number of oocytes retrieved in the previous ART cycle and current AFC were predictive of LB (AUC 0.76, 0.75) for the older women. Conclusions MTX does not influence ovarian reserve, response to gonadotropin stimulation, and CP or LB rate after ART. MTX remains a safe and effective treatment option for women with asymptomatic EPs.Capsule As treatment for an ectopic pregnancy, methotrexate does not affect ovarian reserve, response to gonadotropin stimulation, clinical pregnancy, or live birth rates in subsequent assisted reproductive tenchology cycles.

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Section: Systematic Reviewmentioning

confidence: 99%

Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes

Boots¹,

Hill²,

Feinberg

et al. 2016

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

“…Mtx treatment has been found to have no effect on ovarian reserve in women with ectopic pregnancy [13] and prognosis of the medical treatment of ectopic pregnancies has been reported as good as that of surgical treatment for subsequent intrauterine pregnancy [14]. However in these studies, the patients had relatively low initial βhCG levels (majority < 5,000 mIU/mL) and received less cumulative Mtx.…”

Section: Discussionmentioning

confidence: 98%

Multidose Methotrexate Treatment of Ectopic Pregnancies with High initial β-Human Chorionic Gonadotropin: Can Success Be Predicted?

Tuğ

Sargın

Yassa

2018

Gynecol Obstet Invest

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Objective: To investigate the clinical results and prognostic factors of multiple dose methotrexate (Mtx) treatment of ectopic pregnancy patients with high initial serum (human chorionic gonadotropin [hCG]). Design: Retrospective cohort study. Patients: Twenty-six ectopic pregnancy patients with serum (βhCG) > 5,000 mIU/mL who received multiple doses of Mtx (1 mg/kg) with folinic acid rescue on the alternating days. Results: Success rate was 88.5%. All failures were tubal ruptures in those who underwent surgery. Median initial hCG values of the success and the failure patients were 8,582 (5,058–31,114) and 5,280 (5,042–13,563) mIU/mL respectively (p > 0.05). Side effects were seen in 18 patients (69.2%, one bone marrow suppression and 17 minor side effects). The number of Mtx injections (7.04 ± 1.71), Mtx dose (71.35 ± 13.16 mg) and follow-up period (42.04 ± 23.77 days) did not differ between groups. Body mass index (BMI), Mtx dose, number of Mtx and change in βhCG levels between the initials and the levels measured 2 days after the 3rd, 4th, and 5th Mtx injections were found to be highly predictive for tubal rupture. Conclusions: Multiple-dose Mtx treatment of ectopic pregnancies with high initial hCG is safe and effective. BMI, Mtx dose, number of Mtx injections and the decrement of βhCG levels were found as highly predictive for the success of the treatment.

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“…Немасштабными когортными исследованиями, проведенными в Турции [20], Израиле [21] и США [19], показано, что хирургическое лечение эктопиче-ской беременности существенно не влияет на овари-альный резерв и результаты вспомогательных репро-дуктивных технологий в дальнейшем. Базальная концентрация ФСГ, эстрадиола, антральный фолли-кулярный счет и объем яичников после оперативно-го лечения оказываются статистически неотличимы-ми от таковых у здоровых женщин или пациенток после консервативного лечения внематочной бере-менности метотрексатом.…”

Section: Discussionunclassified

“…В литературе представлены исследования, опи-сывающие отрицательное воздействие СЭ на овари-альный резерв [9][10][11][12][13][14][15][16], косвенные доказательства снижения функции яичников [17] и данные об от-сутствии влияния операции на женские гонады [8,[18][19][20][21][22].…”

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Ovarian reserve after preventive salpingectomy

Petrov¹,

Логвинов²,

Tikhonovskaya³

et al. 2015

Probl. reprod.

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Effect of single-dose methotrexate on ovarian reserve in women with ectopic pregnancy

Cited by 27 publications

References 17 publications

Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes

Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes

Multidose Methotrexate Treatment of Ectopic Pregnancies with High initial β-Human Chorionic Gonadotropin: Can Success Be Predicted?

Ovarian reserve after preventive salpingectomy

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