Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle

Abstract

Ectopic pregnancy is a known risk for patients treated with IVF. The objective of this study was to evaluate the effect of methotrexate (MTX) and laparoscopic salpingectomy as treatments of ectopic pregnancy on ovarian response during IVF cycles. Data of all women treated for ectopic pregnancy as a result of IVF treatment were evaluated; the study included women who had an unruptured ectopic pregnancy after IVF treatment that was treated with either MTX or laparoscopic salpingectomy and underwent a subsequent IVF cycle. The main outcome measures were baseline serum FSH concentrations and ovarian response in the subsequent IVF cycle after treatment of ectopic pregnancy. Of a total of 58 patients, 36 were previously treated with MTX and 22 others by salpingectomy. No significant differences were observed between the MTX and the salpingectomy groups in the parameters of ovarian response in the subsequent IVF cycle.

Does salpingectomy have a deleterious impact on ovarian response in in vitro fertilization cycles?

“…After the final screening, 12 of the studies were retrospective (1,4,9,(22)(23)(24)(25)(26)(27)(28)(29)(30) and six were prospective (5,8,(31)(32)(33)(34). Publication years of the eligible studies ranged from 1994 to 2013.…”

“…Publication years of the eligible studies ranged from 1994 to 2013. The studies were conducted in Belgium (24), Canada (22,27), China (25,33,34), Egypt (32), Israel (1,9,26,27,30), Sweden (5), the United Kingdom (4,24), and the United States (23,28,29,31). Table 1 shows the study characteristics in detail.…”

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

“…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]. As shown in Table 1, five of the studies were retrospective cohort analyses and two were prospective observational studies [19,20].…”

“…As shown in Table 1, five of the studies were retrospective cohort analyses and two were prospective observational studies [19,20]. All of the studies used a paired analysis of IVF cycles before and after MTX, but two studies also compared to a control group of patients who underwent salpingectomy [17,22]. The majority of these studies are limited by their retrospective nature and sample size.…”

Ovarian reserve after preventive salpingectomy

“…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].…”