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Middle East Fertility Society Journal
Middle East Fertility Society
ISSN: 1110-5690
Vol. 12, No. 1, 2007, pp. 57-62
Bioline Code: mf07010
Full paper language: English
Document type: Research Article
Document available free of charge

Middle East Fertility Society Journal, Vol. 12, No. 1, 2007, pp. 57-62

 en Single dose methotrexate for treatment of ectopic pregnancy: risk factors for treatment failure
Eskandar, Mamdoh


Objective: To identify risk factors for single dose methotrexate (MTX) failure among patients treated for ectopic pregnancies. Design: Retrospective cohort.
Materials and methods: Seventy women diagnosed with an ectopic gestation treated with MTX. After a single dose, 66 (94.3%) patients experienced ectopic resolution, three (4.3%) patients needed a second dose of MTX, and one (1.4%) patient had a subsequent tubal rupture.
Main outcome measure(s): Predictive variables for failure of single dose MTX, including human chorionic gonadotropin (hCG) value, fetal sac size, patient age, parity and history of previous miscarriages.
Result(s): Ectopic pregnancies that failed to resolve following a single dose MTX were associated with increased maternal age, history of spontaneous abortions, larger sac sizes (>3.4 cm), and higher β-HCG levels (>2000 mIU/mL). Multiple regression analysis demonstrated that the size of the embryonic sac was the most important variable in failures of single dose methotrexate treatment.
Conclusion: Size of gestational sac and the pre-treatment level of HCG should be considered as independent risk factors for treatment failure of single dose methotrexate treatment.

Ectopic pregnancy, methotrexate, human chorionic gonadotropin, embryonic sac size, tubal rupture.

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