Methotrexate treatment for ectopic pregnancy after assisted reproductive ă technology: A case-control study
Résumé
Objectives. - Ectopic pregnancy (EP) occurs in 2% to 5.6% of ă pregnancies achieved by assisted reproductive technology (ART). EP ă treatment options include medical treatment by uses of methotrexate ă (MTX) systemic injection. The objective of this study was to compare MTX ă treatment effectiveness for EP occurring spontaneously or following ART. ă Methods. - A case-control study performed in the department of ă obstetrics and gynecology at a tertiary health care center in France. ă Twenty EP achieved by ART (ART group) and 60 spontaneous EP (SEP group) ă received MTX treatment between January 2002 and May 2012. The main ă outcome measures were MTX treatment failure rates, number of MTX ă injections administered and recovery time. ă Results. - MTX treatment failure rates observed in ART and SEP groups ă were similar (3/20 [15%] versus 10/60 [17%]: OR = 0.88 ă [0.22-3.58]). Mean duration of recovery time in patients with ă successful MTX treatment did not differ between ART and SEP groups (33 ă 14 days versus 28 13 days, P = 0.39). A second MTX injection was ă required more frequently in ART group than in SEP group (10/20 [50%] ă versus 10/60 [17%]: OR= 5 [1.65-15.15]). ă Conclusions. - It is concluded that MTX treatment is equally effective ă for spontaneous EP and EP achieved by ART, two injections of MTX being ă more frequently required in case of ART. (C) 2016 Elsevier Masson SAS. ă All rights reserved.