Aim: Methotrexate (MTX) treatment at a dose of 50 mg/m of body surface area (BSA) is an effective and widely used treatment method in ectopic pregnancy. However, there is a limited number of studies investigating lower MTX doses. In this study, we aimed to investigate the efficacy of lower MTX doses in the treatment of ectopic pregnancy.
Methods: This retrospective study included a total of 112 patients who were hospitalized due to ectopic pregnancy and administered single-dose MTX. The patients were divided into three groups according to the dose given as 22-40 mg/m of BSA (n = 17), 41-49 mg/m of BSA (n = 81) and ≥ 50 mg/m of BSA (n = 14). Data including demographic characteristics of the patients, previous history of ectopic pregnancy, previous gynecological surgeries, the use of in vitro fertilization techniques, ultrasonographic findings, beta-human chorionic gonadotropin hormone (β-hCG) levels, pre-treatment endometrial sampling, MTX doses applied, and the need for a surgical intervention during follow-up were retrieved from the hospital records.
Results: Of the patients, 16.96% (n = 19) were operated at the end of treatment, irrespective of the pre-treatment β-hCG levels with a success rate of 83% (n = 93). Fourteen (12.5%) of the patients received the second dose of MTX. The overall success rate was 89.2% in patients with a β-hCG level of ≤5000 mIU/mL.
Conclusion: This study shows that lower MTX doses than 50 mg/m , which has been considered standard treatment and widely used in the treatment of ectopic pregnancy for nearly three decades, are effective with similar success rates.
Background: Abdominal pregnancy is a rare but, serious obstetric condition that has continued to pose difficulties in its diagnosis and management. The clinical presentation takes various forms, mostly nonspecific, leading to the delay in diagnosis and management. With a high degree of suspicion, the diagnosis can be made by an abdominal ultrasound particularly in the early trimesters.
Purpose: Ectopic pregnancy (EP) constitutes 1-2% of all pregnancies. Methotrexate (MTX) is commonly used in treating EP, but it has some limitations and potential side effects. Clinical studies have shown that letrozole, an aromatase inhibitor, may potentially be used in conjunction with MTX therapy.
Ectopic pregnancies are uncommon among women presenting for abortion. However, where suspected, rapid referral for definitive diagnosis is essential to prevent harm. We assessed whether implementation of a standardised decision-making tool, an algorithmic representation of the clinical decisions and associated actions defined in policy, in a British abortion service was associated with a reduction in missed opportunities to escalate care where indicated.
Background: To evaluate the risk factors associated with WOI (window of implantation) displacement based on ERT (endometrial receptivity test), and to confirm the association of ectopic pregnancy with WOI displacement.
Methods: This is a retrospective study at the Reproductive Medicine Center of Xiangya Hospital from January 2020 to April 2024, consisting of 934 patients who performed ERT. The patients underwent 3771 assisted reproductive technology (ART) cycles and 2629 embryo transfer (ET) cycles, with each patient experiencing at least one implantation failure.
