Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle

Abstract

Ectopic pregnancy is a known risk for patients treated with IVF. The objective of this study was to evaluate the effect of methotrexate (MTX) and laparoscopic salpingectomy as treatments of ectopic pregnancy on ovarian response during IVF cycles. Data of all women treated for ectopic pregnancy as a result of IVF treatment were evaluated; the study included women who had an unruptured ectopic pregnancy after IVF treatment that was treated with either MTX or laparoscopic salpingectomy and underwent a subsequent IVF cycle. The main outcome measures were baseline serum FSH concentrations and ovarian response in the subsequent IVF cycle after treatment of ectopic pregnancy. Of a total of 58 patients, 36 were previously treated with MTX and 22 others by salpingectomy. No significant differences were observed between the MTX and the salpingectomy groups in the parameters of ovarian response in the subsequent IVF cycle. Repeat ectopic pregnancy was encountered in one patient in each group with a total rate of 3.4% (2/58). No significant differences were found in the outcomes of the subsequent pregnancy after treatment with MTX or salpingectomy. It is concluded that neither prior MTX treatment nor salpingectomy affect ovarian response in the subsequent IVF cycle.Ectopic pregnancy is a known risk for patients treated with IVF. The objective of our study was to evaluate the effect of methotrexate (MTX) and salpingectomy as treatments of ectopic pregnancy on ovarian response during IVF cycles. We evaluated data of all women treated for ectopic pregnancy as a result of IVF treatment. We included women who had an unruptured ectopic pregnancy after IVF treatment that was treated with either MTX or laparoscopy and underwent a subsequent IVF cycle within 12months after the ectopic pregnancy. The main outcome measures were baseline serum FSH concentrations and ovarian response in the subsequent IVF cycle after treatment of ectopic pregnancy. Of a total of 58 patients, 36 were previously treated with MTX and 22 others by salpingectomy. Baseline serum FSH concentrations and ovarian responses before and after treatment of ectopic pregnancy were comparable. Moreover, while comparing the basal FSH concentrations and parameters of ovarian response in the subsequent IVF cycle, no significant differences were observed between the methotrexate and the salpingectomy groups. Repeat ectopic pregnancy was encountered in one patient in each group, with a total rate of 3.4% (2/58). No significant difference was found in the outcome of the subsequent pregnancy after treatment with MTX or salpingectomy. From our results, we conclude that neither prior methotrexate treatment nor salpingectomy affect ovarian response in the subsequent IVF cycle.