Document Detail

Effect of methotrexate exposure on subsequent fertility in women undergoing controlled ovarian stimulation.
MedLine Citation:
PMID:  18829004     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the pregnancy rate, ovarian responsiveness, and endometrial thickness in infertility patients with a history of methotrexate exposure who subsequently underwent controlled ovarian stimulation. DESIGN: Retrospective cohort study. SETTING: University reproductive endocrinology and infertility program. SUBJECT(S): Forty-eight women with infertility undergoing ovarian stimulation after receiving methotrexate treatment for ectopic gestation. INTERVENTION(S): Methotrexate administration and controlled ovarian stimulation. MAIN OUTCOME MEASURE(S): Pregnancy rate, cycle day 3 FSH levels, number of oocytes retrieved, and endometrial thickness. RESULT(S): The cumulative intrauterine pregnancy rate achieved with controlled ovarian stimulation at 2 years after methotrexate exposure was 43%, with a mean time to conceive of 181 days. Thirty-five patients with similar fertility treatments pre- and post-methotrexate were identified. Within this group, when an IVF cycle occurred within 180 days of methotrexate exposure, a significant decline in oocytes retrieved was observed. Cycles performed later than 180 days after methotrexate exposure did not exhibit a decrease in oocyte production. Endometrial development was similar at all time points examined. CONCLUSION(S): These findings suggest a time-limited and reversible impact of methotrexate on oocyte yield. If confirmed by larger clinical series and/or animal data, these results may impact the management of ectopic gestation in the patient with a history of infertility or the timing of subsequent treatments.
Janet F McLaren; Richard O Burney; Amin A Milki; Lynn M Westphal; Michael H Dahan; Ruth B Lathi
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Publication Detail:
Type:  Journal Article     Date:  2008-10-01
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-03     Completed Date:  2009-08-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  515-9     Citation Subset:  IM    
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA.
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MeSH Terms
California / epidemiology
Cohort Studies
Folic Acid Antagonists / administration & dosage
Infertility, Female / epidemiology*,  therapy*
Methotrexate / administration & dosage*
Ovulation Induction / methods*
Pregnancy Outcome / epidemiology*
Pregnancy, Ectopic / drug therapy*,  epidemiology*
Retrospective Studies
Treatment Outcome
Reg. No./Substance:
0/Folic Acid Antagonists; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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