title: Pretreatment serum human chorionic gonadotropin cutoff value for medical treatment success with single-dose and multi-dose regimen of methotrexate in tubal ectopic pregnancy.
abstract: OBJECTIVE
  To investigate individual pretreatment serum human chorionic gonadotropin (hCG) cutoff value for medical treatment success with single-dose and multi-dose regimen of methotrexate in tubal ectopic pregnancy.
  
  
  METHODS
  Eighty-five women who received methotrexate for the treatment of tubal ectopic pregnancy during 2003 to 2015 were selected. Fifty-three women received a single-dose regimen and 32 women received a multi-dose regimen. Medical treatment failure was defined as necessity of surgical treatment. The medical treatment success rate was estimated in both regimens and the pretreatment serum hCG titer to predict the success was assessed by receiver operating characteristics curve analysis.
  
  
  RESULTS
  Pretreatment clinical and laboratory parameters were similar between group of single-dose regimen and multi-dose regimen. Treatment success rate was 64.2% in the single-dose regimen group and 71.9% in the multi-dose regimen group (P>0.05). Pretreatment serum hCG titer was an independent prognostic factor for treatment success in each regimen. Serum hCG cutoff value to predict the treatment success was 3,026 IU/L in single-dose regimen group and 3,711 IU/L in multi-dose regimen group.
  
  
  CONCLUSIONS
  We recommend use of single-dose regimen when pretreatment serum hCG <3,026 IU/L but multi-dose regimen may be favored when initial serum hCG level between 3,026 and 3,711 IU/L.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Junhwan
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Jung
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Da Yong
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Byung Chul
authors.identifier: 0000-0003-2289-6090
authors.initials: BC
authors.lastname: Jee
keywords: Chorionic gonadotropin; Methotrexate; Pregnancy, tubal