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Evaluation of the effect of multi-dose methotrexate therapy on ovarian reserve in ectopic pregnancies: is polycystic ovarian morphology a protective condition for ovarian reserve?
, 2, 2
Affiliations- Department of Obstetrics and Gynecology, Dr Ersin Arslan Education and Research Hospital, Gaziantep, Türkiye
- Department of Obstetrics and Gynecology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
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Abstract
Objectives: The study aims to evaluate the effects of multi-dose methotrexate (MTX) or subsequent salpingectomy on ovarian reserve and explain the conditions that cause the change in serum anti-müllerian hormone (AMH) levels.
Material and methods: Our department had 58 tubal ectopic pregnancy (EP) patients treated with a multiple-dose MTX protocol or subsequent salpingectomy between 2017–2020. Serum AMH level was measured in each patient before the medication and 3–6 months after therapy. Patients’ details were recorded and analyzed later.
Results: The mean AMH value decreased in 32 patients (−17.8%), increased in 26 patients (+31.5%) (p < 0.0001). In the group with an increase, there was a significantly high number of patients with a polycystic ovary (PCO) condition compared to the other group (p = 0.0001). The post-treatment serum AMH levels increased in patients with PCO, whereas those decreased in patients without PCO (p < 0.001).
Conclusions: Multiple-dose MTX or subsequent salpingectomy treatment in tubal ectopic pregnancy (EP) patients might not refer to significant differences in patients’ AMH levels. Remarkably, post-treatment AMH levels were significantly increased in EP patients with PCO and decreased in those without this condition. PCO may be a protective condition for ovarian reserve.
Abstract
Objectives: The study aims to evaluate the effects of multi-dose methotrexate (MTX) or subsequent salpingectomy on ovarian reserve and explain the conditions that cause the change in serum anti-müllerian hormone (AMH) levels.
Material and methods: Our department had 58 tubal ectopic pregnancy (EP) patients treated with a multiple-dose MTX protocol or subsequent salpingectomy between 2017–2020. Serum AMH level was measured in each patient before the medication and 3–6 months after therapy. Patients’ details were recorded and analyzed later.
Results: The mean AMH value decreased in 32 patients (−17.8%), increased in 26 patients (+31.5%) (p < 0.0001). In the group with an increase, there was a significantly high number of patients with a polycystic ovary (PCO) condition compared to the other group (p = 0.0001). The post-treatment serum AMH levels increased in patients with PCO, whereas those decreased in patients without PCO (p < 0.001).
Conclusions: Multiple-dose MTX or subsequent salpingectomy treatment in tubal ectopic pregnancy (EP) patients might not refer to significant differences in patients’ AMH levels. Remarkably, post-treatment AMH levels were significantly increased in EP patients with PCO and decreased in those without this condition. PCO may be a protective condition for ovarian reserve.
Keywords
anti-müllerian hormone; ectopic pregnancy; methotrexate; ovarian reserve; salpingectomy
About this articleTitle
Evaluation of the effect of multi-dose methotrexate therapy on ovarian reserve in ectopic pregnancies: is polycystic ovarian morphology a protective condition for ovarian reserve?
Journal
Issue
Article type
Research paper
Pages
407-414
Published online
2022-08-24
Page views
1967
Article views/downloads
734
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(5):407-414.
Keywords
anti-müllerian hormone
ectopic pregnancy
methotrexate
ovarian reserve
salpingectomy
Authors
Furkan Çetin
Neslihan Bayramoglu Tepe
Ali Irfan Kutlar
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