title: The effect of parental 5,10-methylenetetrahydrofolate reductase 677C/T and 1298A/C gene polymorphisms on response to single-dose methotrexate in tubal ectopic pregnancy.
abstract: OBJECTIVE
  The aim of this study was to assess the effect of parental 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms (677C/T and 1298A/C) on response to single-dose methotrexate (MTX) treatment in tubal ectopic pregnancy (TEP).
  
  
  METHODS
  In this prospective cohort study, cases with unruptured TEPs were grouped into two according to their response to single-dose MTX treatment (Group 1: responsive, n:88; Group 2: unresponsive, n:21). The groups were compared with regard to baseline demographic and clinical parameters. As a main outcome measure, the independent effects of parental MTHFR gene polymorphisms on response to single dose MTX treatment were evaluated.
  
  
  RESULTS
  One hundred and nine unruptured TEP were included in the final analysis. The mean maternal age was 29.30 ± 5.21 years, gravity 2 (min-max: 1-5), parity 1 (min-max: 0-4). The median serum beta-human chorionic gonadotropin (β-hCG) was 1403.35 MI/I (Q1-Q3: 517-2564). The overall response rate was 81% (88/109). The groups were similar with respect to basic baseline demographic data and serum β-hCG level. Binary logistic regression analysis showed that the presence of parental MTHFR677C/T and 1298A/C polymorphism were not independent factor predicting treatment success (p > 0.05). The only independent factor for resistance to single dose MTX was the previous TEP (OR: 4.47 (1.18-16.9)).
  
  
  CONCLUSIONS
  Parental MTHFR 677C/T and 1298A/C mutations do not predict the outcome of single dose intramuscular MTX treatment in unruptured TEP.
authors.affiliation: a Department of Obstetrics and Gynecology , Erciyes University , Kayseri , Turkey and.
authors.forename: Mehmet Serdar
authors.initials: MS
authors.lastname: Kutuk
authors.affiliation: b Department of Medical Genetics , Faculty of Medicine, Erciyes University , Kayseri , Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Subasioglu
authors.affiliation: a Department of Obstetrics and Gynecology , Erciyes University , Kayseri , Turkey and.
authors.forename: Semih
authors.initials: S
authors.lastname: Uludag
authors.affiliation: b Department of Medical Genetics , Faculty of Medicine, Erciyes University , Kayseri , Turkey.
authors.forename: Nazife
authors.initials: N
authors.lastname: Tascioglu
authors.affiliation: a Department of Obstetrics and Gynecology , Erciyes University , Kayseri , Turkey and.
authors.forename: Mahmut Tuncay
authors.initials: MT
authors.lastname: Ozgun
authors.affiliation: b Department of Medical Genetics , Faculty of Medicine, Erciyes University , Kayseri , Turkey.
authors.forename: Munis
authors.initials: M
authors.lastname: Dundar
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D009154:Mutation; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*; D011446:Prospective Studies; D012044:Regression Analysis; D013763:Tetrahydrofolates / Q000235:genetics*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D013763:Tetrahydrofolates; C013123:5,10-methylenetetrahydrofolic acid; D008727:Methotrexate
keywords: Ectopic pregnancies; gene polymorphism; methotrexate; methylenetetrahydrofolate reductase