Evaluation of Factors Associated with the Success of Single-Dose Methotrexate Treatment in Ectopic Pregnancy Ektopik Gebelikte Tek Doz Metotreksat Tedavisinin Başarısıyla İlişkili Faktörlerin Değerlendirilmesi

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Saridaş Demir S., DEMİR B., Şahin Ö., Şahin H. Ö., Toktaş İ. U., ÜNSAL M. A., ...Daha Fazla

Turkish Journal of Reproductive Medicine and Surgery, cilt.10, sa.2, ss.56-61, 2026 (Scopus, TRDizin)

Özet

Objective: This study aimed to evaluate demographic, clinical, ultrasonographic, and laboratory factors associated with the success of single-dose methotrexate treatment in ectopic pregnancy. Material and Methods: This retrospective observational study included 57 patients who received a single intramuscular dose of methotrexate at 50 mg/m2 for ectopic pregnancy or pregnancy of unknown location. Patients were divided into the successful medical therapy group and the failed medical therapy group. Treatment success was defined as a decrease of at least 15% in serum beta-human chorionic gonadotropin (β-hCG) levels between days 4 and 7 after methotrexate administration, or a decline of β-hCG to below 5 IU/L during follow-up. Demographic, clinical, ultrasonographic, and laboratory parameters were compared between the groups. Results: Single-dose methotrexate treatment was successful in 36 of 57 patients (success rate 63.2%). Treatment failed in 21 patients. Age, obstetric history, gestational age, ectopic mass size, and previous tubal factors were comparable between the groups. Pretreatment β-hCG levels were higher in the failed therapy group with borderline statistical significance. β-hCG levels measured on days 1, 4, and 7 after methotrexate administration were significantly higher in the failed therapy group. Conclusion: Baseline demographic and clinical variables were not significantly associated with single-dose methotrexate treatment outcome. Serial β-hCG monitoring after treatment, particularly on days 4 and 7, was associated with treatment outcome and remains an important component of clinical follow-up. Larger prospective studies are needed to develop reliable prediction models.