Effect of Single and Multiple Methotrexate Doses Treatment on Ovarian Reserve in Ectopic Pregnancy Women: A Prospective Cohort Study.

Background One of the main concerns for women diagnosed with ectopic pregnancy (EP). This study has been designed to evaluate the potential effects of methotrexate (MTX) single and multi-dose exposures on the ovarian reserve.

This was a prospective observational cohort study that was held in the Imam Khomeini Hospital, Ahvaz, Iran, from June 2021 to October 2022. Demographic information such as (age, body mass index (BMI), gravid, and parity) were recorded. Follicle stimulation hormone (FSH), estradiol plasma levels (on day 3 of the cycle), and Anti-Mullerian Hormone (AMH) were measured two times before MTX administration (pre-treatment) and then eight weeks after treatment (post-treatment). Also, antral follicle count (AFC) was evaluated by trans-vaginal ultrasound pre- and post-treatment.

One hundred and seventy-two patients were recruited into the study. There was no difference in levels of FSH, AMH and AFC between single-dose and multiple-dose groups. There was only a statistically significant difference in estradiol levels between the two groups (P: 0.02), and estradiol concentrations were higher in the multiple-dose MTX group.

Administration of MTX (regardless of number of doses) has no negative effect on ovarian reserve and is safe to be used as a treatment for EP. Similar content being viewed by others

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SH.SH, F.M carried out the analysis of data, drafted the manuscript. N.SH and SH.SH revised it, drafted the manuscript, and approved the final version that was submitted. Corresponding author Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Ethical Approval IR.AJUMS.HGOLESTAN.REC.1400.068. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Mahvash Zargar and Farideh Moramezi are Associate Professor; Shiva ShahAli is an MD; and Nahid Shahbazian is a Professor Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Zargar, M., ShahAli, S., Moramezi, F. et al. Effect of Single and Multiple Methotrexate Doses Treatment on Ovarian Reserve in Ectopic Pregnancy Women: A Prospective Cohort Study. J Obstet Gynecol India 75, 22–27 (2025). https://doi.org/10.1007/s13224-023-01939-5 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s13224-023-01939-5