Comparison of the effect of single-dose and multiple-dose methotrexate therapy on tubal patency.
OBJECTIVE
To compare tubal patency by using hysterosalpingography (HSG) in women with unruptured ectopic tubal pregnancy who were treated with either single-dose or multiple-dose methotrexate (MTX) regimen.


METHODS
A case series with a retrospective statistical analysis.


METHODS
Maternity and teaching hospital in Turkey.


METHODS
Sixty-one patients treated with MTX therapy for unruptured tubal ectopic pregnancy.


METHODS
Thirty-one patients received single-dose and 30 multiple-dose MTX treatment. The HSG was performed 4 to 6 months after treatment to assess tubal patency.


METHODS
Ipsilateral and contralateral tubal obstruction rates.


RESULTS
Free passage through the ipsilateral tube was observed in 17 of 30 cases (56.7%) after multiple-dose, and 26 of 31 cases (83.9%) after single-dose MTX therapy. Patency of the contralateral tube was higher after single-dose than multiple-dose MTX treatment, although the value was not statistically significant. Binary logistic regression analysis was used to evaluate the parameters of age, gravida, parity, initial titers of beta human chorionic gonadotropin, size of the adnexal mass, and MTX regimen and their correlation with the HSG results after the clinical treatment for unruptured ectopic pregnancy. Only the type of MTX regimen was found to be used as a predictor of ipsilateral tubal obstruction.


CONCLUSIONS
In terms of ipsilateral tubal obstruction, multiple-dose MTX therapy appears to have a greater negative effect on tubal patency than single-dose therapy.
Guven
Emine Seda Guvendag
ES
Department of Obstetrics and Gynecology, Etlik Womens' Health and Teaching Hospital, Ankara, Turkey. emineseda@yahoo.com
Dilbaz
Serdar
S
Dilbaz
Berna
B
Ozdemir
Dilek Sahin
DS
Akdag
Derya
D
Haberal
Ali
A
D000328:Adult; D004334:Drug Administration Schedule; D005187:Fallopian Tubes / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000188:drug therapy*; D011274:Pregnancy, Tubal / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D012189:Retrospective Studies
D008727:Methotrexate