Is it possible to predict the success of single dose methotrexate in the treatment of tubal ectopic pregnancies?

Abstract

Objectives: In this study, the aim was to determine whether the use of endometrial thickness or neutrophil/lymphocyte and platelet/lymphocyte ratio would be useful in predicting the success of methotrexate in the treatment of ectopic pregnancies located in the fallopian tubes.Materal and methods:This study was carried out by retrospectively examining 68 study group cases with an ultrasono-graphically detectable gestational sac in the fallopian tubes and 189 control group cases with an unruptured ectopic pregnancy diagnosis at any location. The cut-off value of endometrial thickness was calculated as a new marker between the cases in which single-dose methotrexate treatment was successful and the cases with treatment failure. Treatment success was evaluated with different models including endometrial thickness, fetal cardiac activity status, measurable crown-rump length, and [3-hCG.Result: The cut-off value of [3-hCG for treatment success was determined as 2960.5 ng/mL, and the cut-off value for endometrial thickness was determined as 10.5 mm. Although NLR seems to be a marker with a cut-off value of 2.49, it does not provide an extra benefit in combined use as it is not a specific predictor. The highest success in predicting treat-ment success was achieved in the modeling in which crown-rump length + fetal cardiac activity + [3-hCG + endometrial thickness were used together.Conclusions: The use of endometrial thickness as a marker seems to be quite reliable in predicting treatment success. And we think it would be beneficial to thin the endometrium before using methotrexate.