In a nutshell
This study examined the use of methotrexate or salpingectomy as a treatment for ectopic pregnancy, and explored whether these treatments affect the chances of subsequent successful in vitro fertilization cycles.
Some background
In-vitro fertilization (IVF) is when a male sperm fertilizes the females’ egg in a laboratory dish outside the body, and is implanted into the woman's uterus (womb). It is commonly used in infertility. IVF may increase the risk of ectopic pregnancy (EP), a pregnancy that does not implant in the uterus but begins to grow in the fallopian tube. An EP is a medical emergency, as it can have serious health and fertility consequences for the mother.
EP can be treated early in the pregnancy using methotrexate (MTX, Trexall) which is a medicine that stops the pregnancy progressing. Salpingectomy involves the surgical removal of the fallopian tube, this procedure is carried out if there is pain associated with the EP and the fetus is larger in size. The effect of these treatments on the success of later IVF treatments is not known.
Methods & findings
This study explored if either of these treatments affected the ovarian reserve (the number of eggs remaining in the female ovaries) and IVF outcomes.
110 females who had an EP and went on to undergo a further fresh IVF cycle within one year were included in this study. 88 of these had been treated with MTX, 22 had undergone a salpingectomy.
There was no difference in the ovarian reserve between the two groups.
There were fewer oocytes retrieved from the post-MTX (10.6) group compared with the pre-MTX group (12.4), but the number that went on to mature were the same in both groups.
The salpingectomy group required a gonadotropin (hormones used to stimulate the production of oocytes) dose 31% higher than the MTX group, but the number of mature oocytes retrieved was similar in both groups.
The overall live birth rate was 32.9% in the MTX group and 36.3% in the salpingectomy group.
The bottom line
This study concluded that treatment of an ectopic pregnancy with methotrexate or salpingectomy may not adversely affect the outcome of future IVF cycles.
The fine print
The number of patients included in this study was relatively small, a larger study be required to produce more accurate results.
What’s next?
Talk to your physician if you are interested in IVF treatment after an ectopic pregnancy.
Published By :
Journal of Minimally Invasive Gynecology
Date :
Apr 24, 2015
