Methotrexate treatment of ectopic pregnancies does not affect ovarian reserve in in vitro fertilization patients

摘要

The incidence of ectopic pregnancies (EP) is estimated to be 1%-2% of all pregnancies, and they account for 5%-6% of all maternal mortality in developed countries. One of the major risk factors of EP is the use of assisted reproductive technologies (ART). The first IVF pregnancy was reported to be ectopic in 1976, and even today the incidence of EP increases threefold when ART is used. The diagnosis of EP relies on early monitoring with serum hCG levels and serial ultrasounds. Early diagnosis is associated with earlier treatment and lower likelihood of complications. EP has traditionally been treated with conservative (salpingostomy) or radical (salpingectomy) surgery, but as early as 1982 medical treatment with methotrexate (MTX) was introduced as a promising alternative. Since then, clinical experience and multiple studies have demonstrated that MTX for the treatment of spontaneous EP is at least equivalent to surgery in terms of safety, efficacy, and return to fertility.