Ultrasound monitoring in patients undergoing in-vitro fertilization after methotrexate treatment for ectopic pregnancy.
OBJECTIVE
To compare sonographic characteristics of the endometrium and follicles during in-vitro fertilization (IVF) before and after methotrexate (MTX) treatment for ectopic pregnancy.


METHODS
This retrospective study, conducted at Conception Hospital from January 2000 to July 2007, included all patients diagnosed with an ectopic pregnancy resulting from IVF treatment that was treated with MTX and who then underwent another IVF cycle. We compared the number and size of follicles and the endometrial thickness and quality on the day of human chorionic gonadotropin injection in the cycles before and after the MTX treatment to determine whether MTX had any effect.


RESULTS
Eleven patients were included in the study. The median interval between the IVF cycle resulting in ectopic pregnancy and the first IVF cycle after MTX therapy was 180 (range, 150-900) days. There was no statistically significant difference between the before and after MTX treatment groups with respect to number of follicles (14 (3-20) vs. 9 (4-16), P = 0.12), follicle size (16.5 (14.7-21.7) mm vs. 17.8 (14.9-19.8) mm, P = 0.37), endometrial thickness (10.0 (9.5-12.0) mm vs. 10.0 (7.5-14.0) mm, P = 0.31) or endometrial quality (P = 0.32). Four women became pregnant during the IVF cycle following MTX treatment.


CONCLUSIONS
Ultrasound monitoring showed no modification of the characteristics of the endometrium or follicles during IVF after MTX treatment for ectopic pregnancy.
Provansal
M
M
Department of Obstetrics and Gynaecology, Conception Hospital, Marseille, France. magali.provansalcheylan@ap-hm.fr
Agostini
A
A
Lacroix
O
O
Gerbeau
S
S
Grillo
J-M
JM
Gamerre
M
M
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging* / Q000187:drug effects; D011247:Pregnancy; D011258:Pregnancy Tests; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D008727:Methotrexate