Methotrexate, a folic acid antagonist, is an effective treatment for early unruptured ectopic pregnancy. Several treatment regimens are available. Methotrexate is more effective when used to treat ectopic pregnancies with lower human chorionic gonadotropin (hCG) levels. However, there is no consensus on a threshold value that best predicts success or failure. Methotrexate can be used to treat ectopic pregnancies that occur in cornual, cervical, and cesarean scar locations, and it does not adversely affect ovarian reserve or subsequent fertility. This document replaces the previous document of the same name, last published in 2008 (Fertil Steril 2008;90:S206-12).
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