Effect of methotrexate treatment of ectopic pregnancy on subsequent pregnancy.
OBJECTIVE
My last pregnancy was diagnosed as ectopic, and I was treated successfully with intramuscular methotrexate (MTX) 8 weeks ago. I am currently planning for another pregnancy; however, I have read that MTX causes birth defects and that it stays in my body for a very long time, ranging from 1 to 12 months after treatment. When is it safe to conceive?


CONCLUSIONS
We suggest that the outcomes of pregnancies conceived shortly after MTX therapy for extrauterine pregnancy are most likely to be favourable and similar to those pregnancies conceived 6 months after MTX treatment. However, as data are not sufficient to draw a definitive conclusion or to confirm the exact safe timing after MTX treatment, at least a 3-month waiting period is recommended for women who are planning pregnancy. Nevertheless, conception within 3 months of MTX treatment of extrauterine pregnancy should not be considered a definite indication of termination, and further targeted fetal anatomy assessment is recommended. Further retrospective and prospective studies are needed to define the safety period before 3 months and to solidify this recommendation.
Rinat
R
Hackmon
Sachi
S
Sakaguchi
Gideon
G
Koren
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005306:Fertilization / Q000187:drug effects; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D016742:Preconception Care; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate
Br Med J (Clin Res Ed). 1984 Jan 14;288(6411):103-6
6318876
Clin Exp Rheumatol. 2009 Jul-Aug;27(4):678-84
19772806
Gynecol Oncol. 2003 Feb;88(2):104-7
12586587
Cancer. 1960 Mar-Apr;13:236-40
13809281
Teratology. 1994 Feb;49(2):79-81
8016747
Can Fam Physician. 2003 May;49:577-8
12790266
Obstet Gynecol. 1991 May;77(5):754-7
2014091
J Rheumatol. 2004 Dec;31(12):2360-5
15570635
Curr Opin Rheumatol. 1996 May;8(3):176-82
8796975
Teratology. 1977 Feb;15(1):73-9
841483
Reprod Toxicol. 2009 Jan;27(1):85-7
19103279
QJM. 1999 Oct;92(10):551-63
10627876
Teratology. 1993 Jun;47(6):533-9
8367826