Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve.
OBJECTIVE
To evaluate whether methotrexate (MTX) compromises ovarian reserve and future reproductive outcome in women undergoing assisted reproductive technology (ART), when it is used as first-line treatment for ectopic pregnancy (EP).


METHODS
Prospective, observational study.


METHODS
University-affiliated private IVF unit.


METHODS
Twenty-five women undergoing IVF-ICSI who were treated with MTX (1 mg/kg IM) for an EP after ART.


METHODS
Evaluation of reproductive outcome and serum anti-Müllerian hormone (AMH) levels. Serum AMH was evaluated before administering MTX and >or=1 week after the resolution of the EP. Reproductive outcome was evaluated by comparing subsequent IVF-ICSI cycles after EP resolution.


METHODS
Serum AMH levels, cycle length, gonadotropin dose required, peak serum E(2) level, oocytes collected, and embryos obtained.


RESULTS
Serum AMH levels before MTX were not statistically significantly different from those after treatment (3.7 +/- 0.3 ng/mL vs. 3.9 +/- 0.3 ng/mL). Patients undergoing a subsequent cycle after systemic treatment for EP had similar cycle durations (10.3 vs. 10.8 d), gonadotropin requirements (2,775 vs. 2,630.3 IU), peak E(2) levels (1,884.3 vs. 1,523.6 pg/mL), number of oocytes retrieved (12.1 vs. 10.5), and total number of embryos obtained (7.1 vs. 6.5).


CONCLUSIONS
Single-dose MTX is a safe first-treatment choice that does not compromise future reproductive outcomes in women who are diagnosed with EP after ART.
IVI-Madrid, Madrid, Spain.
Bárbara
B
Oriol
Ana
A
Barrio
Alberto
A
Pacheco
José
J
Serna
José Luis
JL
Zuzuarregui
Juan A
JA
Garcia-Velasco
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use*; D054304:Anti-Mullerian Hormone / Q000097:blood*; D010064:Embryo Implantation / Q000187:drug effects; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007246:Infertility / Q000378:metabolism / Q000628:therapy*; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D054315:Oocyte Retrieval; D010050:Ovarian Function Tests; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects
D000020:Abortifacient Agents, Nonsteroidal; D006062:Gonadotropins; D004958:Estradiol; D054304:Anti-Mullerian Hormone; D008727:Methotrexate