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

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Abstract

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgment

The authors wish to acknowledge the support of the deputy of research affairs of the Ahvaz Jundishapur University of Medical Sciences as part of Shiva ShahAli’s thesis under the research code FIRC-0012.

Funding

Ahvaz Jundishapur University of Medical Sciences Number: FIRC-0012.

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Authors and Affiliations

  1. Fertility, Infertility and Perinatology Research Center, Department of Obstetrics and Gynecology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mahvash Zargar, Shiva ShahAli, Farideh Moramezi & Nahid Shahbazian

Authors
  1. Mahvash Zargar
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  2. Shiva ShahAli
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  3. Farideh Moramezi
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  4. Nahid Shahbazian
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Contributions

M.Z conceived the original idea, designed the scenarios, and collected the data. 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

Correspondence to Mahvash Zargar.

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The authors declare that they have no conflict of interest.

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IR.AJUMS.HGOLESTAN.REC.1400.068.

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Mahvash Zargar and Farideh Moramezi are Associate Professor; Shiva ShahAli is an MD; and Nahid Shahbazian is a Professor

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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 (2024). https://doi.org/10.1007/s13224-023-01939-5

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