Comparison of the long-term effects of single-dose methotrexate and salpingectomy on ovarian reserve in terms of anti-müllerian hormone levels

Abstract

The aim of this study was to compare the effects of single-dose methotrexate (MTX) and salpingectomy on ovarian reserve in women with ectopic pregnancy in the late post-treatment period. A total of 181 patients were included in the study; 56 of them received a single-dose of MTX, 45 of them had undergone salpingectomy treatment for ectopic pregnancy in the previous 12–18 months, and 80 healthy women constituted an age-matched control group. The anti-müllerian hormone (AMH), follicle stimulating hormone (FSH) and oestrogen (E₂) levels, as well as antral follicle counts (AFC) of the patients were evaluated. The average age was similar in both groups (p = 0.094) and there was no statistically significant difference in the smoking status of the patients (p = 0.949). None of the three groups displayed a significant difference in terms of AFC (p = 0.528), AMH (p = 0.147), FSH (p = 0.393) and E₂ levels (p = 0.117). In the treatment of ectopic pregnancy neither the single-dose MTX application nor the salpingectomy had any permanent detrimental effect on the ovarian reserve; serum AMH levels and AFC are unaltered in the long term following single-dose MTX or salpingectomy.

Keywords:

• Anti-müllerian hormone
• antral follicle count
• ectopic pregnancy
• methotrexate
• ovarian reserve
• salpingectomy

Acknowledgements

The authors thank Burak Ersoy, Assoc. Prof. (Maltepe University School of Medicine, Istanbul, Turkey); Demetra Hufnagel (Yale University School of Medicine, New Haven, CT, USA) for their assistance with manuscript review and editing.

Disclosure statement

None of the authors has any conflict of interest relative to this work.