title: Conservative treatment of ectopic pregnancy and its effect on corpus luteum activity.
abstract: Corpus luteum activity was monitored in 15 women undergoing nonsurgical management of ectopic pregnancy with local methotrexate injection followed by alternating oral methotrexate and citrovorum factor (group A, n = 8) or local methotrexate injection alone (group B, n = 7). All patients initially demonstrated a viable corpus luteum (plasma progesterone ranged from 1.4 to 19 ng/ml). The treatment was successful in 14, with the exception of one whose tube ruptured 11 days after local administration of methotrexate, despite a continuous decrease in beta human chorionic gonadotropin, 17 beta-estradiol and plasma progesterone levels. There seems to be no correlation between the success of the treatment and the behavior of beta human chorionic gonadotropin, 17 beta-estradiol and plasma progesterone. Three patients from group A and two from group B displayed an initial rise in beta human chorionic gonadotropin following the initiation of the therapy, but the corpus luteum response differed. In group B patients, 17 beta-estradiol and plasma progesterone levels increased in parallel with beta human chorionic gonadotropin. Group A patients displayed a continuous decrease in 17 beta-estradiol and plasma progesterone levels despite the elevation of beta human chorionic gonadotropin, suggesting a possible effect of the systemic methotrexate on corpus luteum activity.
authors.affiliation: Department of Obstetrics and Gynecology B, Sapir Medical Center, Kfar Saba, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shulman
authors.forename: R
authors.initials: R
authors.lastname: Maymon
authors.forename: N
authors.initials: N
authors.lastname: Zmira
authors.forename: M
authors.initials: M
authors.lastname: Lotan
authors.forename: M
authors.initials: M
authors.lastname: Holtzinger
authors.forename: C
authors.initials: C
authors.lastname: Bahary
mesh_terms: D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D003338:Corpus Luteum / Q000187:drug effects / Q000502:physiology*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008727:Methotrexate / Q000494:pharmacology / Q000627:therapeutic use; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D011274:Pregnancy, Tubal / Q000188:drug therapy / Q000628:therapy; D011374:Progesterone / Q000097:blood
chemical_list: D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D011374:Progesterone; D004958:Estradiol; D002955:Leucovorin; D008727:Methotrexate