Fertility outcome following combined methotrexate treatment of unruptured extrauterine pregnancy.
OBJECTIVE
To assess the effectiveness of systemic treatment with methotrexate in combination with local injection for unruptured tubal pregnancy, and to evaluate reproductive function following treatment.


METHODS
Prospective, open clinical study.


METHODS
University clinic.


METHODS
Sixty-seven women with unruptured tubal pregnancy.


METHODS
Systemic methotrexate (intramuscular methotrexate 0.5 mg/kg for up to five days) in combination with local application of 12.5 mg methotrexate via laparoscopy.


METHODS
The subsequent surgical intervention required and future fertility.


RESULTS
In 89.6% of women no further surgical intervention was required and 47 women (81%) experienced subsequently an intrauterine pregnancy. In 39 of 40 women who underwent hysterosalpingography following treatment, patency of the affected tube was observed.


CONCLUSIONS
Combined local and systemic methotrexate treatment for unruptured tubal pregnancy seems to be more effective than each therapeutic modality alone.
Debby
A
A
Department of Obstetrics and Gynaecology, The Edith Wolfson Medical Center, Holon and Sackler Medical School, Tel Aviv, Israel.
Golan
A
A
Sadan
O
O
Zakut
H
H
Glezerman
M
M
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism; D003131:Combined Modality Therapy; D005260:Female; D005298:Fertility / Q000187:drug effects; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011274:Pregnancy, Tubal / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D011446:Prospective Studies; D012489:Salpingostomy; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate