Methotrexate as a possible cause of ovarian cysts formation: experience with women treated for ectopic pregnancies.
OBJECTIVE
To evaluate ovarian morphology after either salpingostomy or local injection of methotrexate (MTX) to cause regression of tubal pregnancies and to define potential correlation to other clinical parameters.


METHODS
Prospective longitudinal follow-up.


METHODS
Department of Obstetrics and Gynecology, Haemek Medical Center, Afula, Israel.


METHODS
One hundred one women who were treated for tubal pregnancy: 58 by salpingostomy and 43 by local MTX injection.


METHODS
Serial blood sampling for beta-hCG and serial transvaginal sonographic evaluation.


METHODS
Appearance of cysts in the ovaries and their location with regard to the side in which the tubal pregnancy occurred.


RESULTS
In 6 of 42 (14.3%) patients who were treated with MTX, multiple (range, three to six) ovarian cysts occurred, as compared with 1 of 55 (1.8%) in those who underwent salpingostomy. The largest cyst was 9.4 cm in diameter. No relation of cyst occurrence to the side of the ectopic pregnancy was recorded. The women who developed cysts did not differ in either initial serum beta-hCG levels or in the rate of its subsequent regression.


CONCLUSIONS
Multiple ovarian cysts may occur in 15% of patients who are treated with intra-amniotic MTX to cause regression of tubal ectopic pregnancy.
Ben-Shlomo
I
I
Department of Obstetrics and Gynecology, Haemek Medical Center, Afula, Israel.
Eliyahu
S
S
Yanai
N
N
Shalev
E
E
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D010048:Ovarian Cysts / Q000139:chemically induced / Q000209:etiology*; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000188:drug therapy* / Q000601:surgery; D011446:Prospective Studies; D012489:Salpingostomy
D019384:Nucleic Acid Synthesis Inhibitors; D008727:Methotrexate