Shirazi Mahboobeh, Pooransari Parichehr, Hajiha Neda, Shaker Zeinab, Ghazi Mohadeseh, Davari Tanha Fatemeh, Ghorbani Yekta Batool, Ghaemi Marjan
Maternal, Fetal and Neonatal Research Center, Tehran, Iran.
Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Int J Fertil Steril. 2020 Apr;14(1):23-26. doi: 10.22074/ijfs.2020.5938. Epub 2020 Feb 25.
The aim of this study was evaluation of the impact of single-dose methotrexate (MTX) treatment on ovarian reserve in women with ectopic pregnancy (EP) undergoing infertility treatment in Iranian population.
This prospective cohort study was done between March 2015 and March 2017 in Tehran General Women Hospital, Tehran, Iran. We enrolled 20 patients with EP who conceived during infertility treatment and received a single-dose MTX (50 mg/m2) intramuscularly. Serum anti-Mullerian hormone (AMH), 17 beta-estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and antral follicle count (AFC) on transvaginal ultrasonography, were evaluated before and 8 weeks after administration of MTX.
AMH did not significantly vary after the administration of MTX, compared to before treatment value (P=0.36). FSH, E2 and AFC changes were not statistically significant, while increment of LH was significant (P=0.02).
Results indicated that single-dose MTX treatment did not reduce ovarian reserve in women with EP. Further randomized controlled clinical trial studies with larger sample sizes, by using multiple dosages of MTX, and with long-term follow up are suggested to be done.
本研究旨在评估单剂量甲氨蝶呤（MTX）治疗对伊朗人群中接受不孕症治疗的异位妊娠（EP）女性卵巢储备功能的影响。
本前瞻性队列研究于2015年3月至2017年3月在伊朗德黑兰综合妇女医院进行。我们纳入了20例在不孕症治疗期间受孕并接受单剂量MTX（50 mg/m²）肌肉注射的EP患者。在给予MTX前及给药8周后，评估血清抗苗勒管激素（AMH）、17β-雌二醇（E2）、黄体生成素（LH）、卵泡刺激素（FSH）以及经阴道超声检查的窦卵泡计数（AFC）。
与治疗前的值相比，给予MTX后AMH无显著变化（P = 0.36）。FSH、E2和AFC的变化无统计学意义，而LH的升高具有统计学意义（P = 0.02）。
结果表明，单剂量MTX治疗并未降低EP女性的卵巢储备功能。建议开展进一步的随机对照临床试验研究，采用更大样本量、多种剂量的MTX，并进行长期随访。
