Evaluation of Ovarian Reserves of Patients who Have Received Methotrexate Treatment Due to Ectopic Pregnancy

INTRODUCTION: The study aimed to investigate the effects of treatment on ovarian reserve in patients who received a single dose of methotrexate (MTX) due to ectopic pregnancy.
METHODS: This prospective study included patients who were diagnosed with ectopic pregnancy in the gynecology and obstetrics clinic of our hospital and met the criteria. The sociodemographic and clinical data of the patients were recorded. Then, MTX was intramuscularly administered at a dose of 50 mg/m2 to eligible patients. Single-dose MTX treatment was considered sufficient in patients with a 15% decrease in serum beta-human chorionic gonadotropin (ß-HCG) concentration between the 4th and 7th days. Weekly ß-HCG follow-ups were undertaken until the ß-HCG levels were negative (5 U/mL). Before starting treatment, serum ß-HCG, complete blood count, and kidney and liver function tests were conducted in all patients. Follicle-stimulating hormone (FSH) and anti-Mullerian hormone (AMH) levels were investigated to evaluate ovarian reserves. 6 months after treatment, the ovarian reserve tests were repeated. The values recorded before and 6 months after treatment were statistically compared.
RESULTS: Thirty-four patients who were diagnosed with an ectopic pregnancy over the study period and met the specified criteria were evaluated. The mean values of investigated parameters were years for age, gravida, parity, body mass index, cm for ectopic focus size, and the baseline β-HCG. Before MTX treatment, the AMH and FSH values were reported. At the end of 6 months after MTX, the AMH and FSH values were determined, respectively. There was no significant difference in the statistical comparison of the serum AMH values before and after 6 months of treatment (p>0.488).
DISCUSSION AND CONCLUSION: Single-dose MTX administration for ectopic pregnancy treatment had no significant effect on ovarian reserves measured according to the parameters mentioned above.