Methotrexate treatment of ectopic pregnancy

The last decade has witnessed an increasing number of reports indicating that ectopic pregnancy (EP) can be successfully and safely treated with methotrexate (MTX). This review summarizes the results. In large series, as many as 45% of a population of women with EP has been treated with MTX. Success rates of 82-95% have been achieved. Tubal patency on the affected side was preserved in 79-91% of the cases. Preliminary assessment of subsequent fertility suggests that 47-69% will obtain an intrauterine pregnancy. Complications have been only few and of minor importance. However, the majority of reports do not include controls. Randomized studies are needed to optimize patient selection, treatment regimens, long-term toxicity, future fertility, and cost-benefits.