title: Ovarian reserve and subsequent assisted reproduction outcomes after methotrexate therapy for ectopic pregnancy or pregnancy of unknown location.
abstract: OBJECTIVE
  To assess ovarian reserve after methotrexate treatment for ectopic pregnancy or pregnancy of unknown location after assisted reproductive technology (ART).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Large ART practice.
  
  
  METHODS
  Women receiving methotrexate or surgery after ART.
  
  
  METHODS
  None.
  
  
  METHODS
  Follicle-stimulating hormone (FSH), antral follicle count (AFC), and oocyte yield compared between women treated with methotrexate or surgery, with secondary outcomes of clinical pregnancy and live birth.
  
  
  RESULTS
  There were 153 patients in the methotrexate group and 36 patients in the surgery group. Neither group demonstrated differences in ovarian reserve or oocyte yield in a comparison of the before and after treatment values. The change in ovarian reserve and oocyte yield after treatment were similar between the two groups. The number of doses of methotrexate was not correlated with changes in ovarian reserve, indicating no dose-dependent effect. Time between treatment and repeat ART was not correlated with outcomes. Live birth in subsequent cycles was similar in the two groups.
  
  
  CONCLUSIONS
  Ovarian reserve and subsequent ART cycle outcomes were reassuring after methotrexate or surgical management of ectopic pregnancy. No adverse impact of methotrexate was detected in this large fertility cohort as has been previously described elsewhere.
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: hillmicah@mail.nih.gov.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.affiliation: Washington Hospital Center, Washington, District of Columbia.
authors.forename: Janelle C
authors.initials: JC
authors.lastname: Cooper
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Gary
authors.initials: G
authors.lastname: Levy
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Connie
authors.initials: C
authors.lastname: Alford
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Richter
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Katz
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Levens
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Erin F
authors.initials: EF
authors.lastname: Wolff
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D054315:Oocyte Retrieval / Q000639:trends*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D027724:Reproductive Techniques, Assisted / Q000639:trends*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D008727:Methotrexate
keywords: ART; ectopic; methotrexate; ovarian stimulation; pregnancy of unknown location; salpingectomy