Ectopic pregnancy

Ectopic pregnancySystemic methotrexate to treat ectopic pregnancy does not affect ovarian reserveThe leading cause of pregnancy-related death in first trimesterEctopic pregnancyThe incidence 1%-2% >>> increases 3x in womenundergoing ARTDiagnosis :Transvaginal UltrasoundSerum hCG

Has been used to successly treat EP since 1982Considered low-risk chemotherapy for fertility preservationMethotrexate Folic acid antagonistCompetitively binds the enzyme dihydrofolic acid reductaseDNA synthesis and repair, celular replication IMPAIRED TetrahydrofolateHas higher intercycle and intracycle reproducibility than markers previously used.Anti-Mllerian Hormone (AMH)One of best markers of ovarian reserveThe purpose of study Evaluate single dose MTX for ectopic pregnancy coompromises ovarian reserveEvaluated AMH in EP women before and after MTX treatmentAnalized cycle outcome before and after MTXJanuary 2005 to November 2006Material and Methods59 (n)25 (n)No intrauterine sacSerum -hCG was > 1.000IU/LSerial -hCG was performedDiagnosed EPAsymptomatic and hemodynamically stableHad the ability and willingness to comply with posttreatment monitoringHad b-hCG of 50 mL in the Douglas pouchHad adnexal mass (if visible) of