A Comparative Analysis of Ovarian Reserve Rates Before and After Ectopic Pregnancy Treatment: A Cross-Sectional Analytical Study

Abstract

Background: Methotrexate (MTX), a folic acid analog, is commonly used in the treatment of ectopic pregnancies. However, its impact on ovarian reserve and function remains controversial, necessitating further investigation. Objectives: This study aimed to compare ovarian reserve rates before and after treatment for ectopic pregnancies. Methods: This cross-sectional analytical study involved women diagnosed with ectopic pregnancy (EP) who sought medical attention at Imam Reza Hospital in Kermanshah between 2019 and 2023. After treatment, patients were categorized into two groups: Single-dose and multiple-dose MTX treatment. The multiple-dose regimen was administered on days 1, 3, 5, and 7. One week after treatment, another blood sample was collected for anti-müllerian hormone (AMH) level measurement. Results: A total of 40 patients diagnosed with EP were evaluated, with 20 patients in the single-dose MTX group and 20 in the multiple-dose MTX group. The average age of all patients was 30.48 ± 3.66 years, with an average parity of 2.10 ± 2. The mean Body Mass Index (BMI) was 28.28 ± 3.95 kg/m2. Both groups were comparable in terms of age, parity, gravidity, BMI, and education level. The study findings indicated that AMH levels did not show a statistically significant decrease (P > 0.05) following treatment in either the single-dose or multiple-dose MTX groups compared to pre-treatment levels. Additionally, when comparing the two treatment methods, no significant differences were observed (P = 0.904). Conclusions: The results demonstrated that AMH levels decreased after EP treatment at different MTX doses compared to pre-treatment levels, but this decrease was not statistically significant. These findings suggest that MTX dosage levels were not associated with significant alterations in ovarian reserve. Notably, no significant dose-dependent effect of MTX on ovarian reserve was observed.