Ginekologia polska · 2022
Evaluation of the effect of multi-dose methotrexate therapy on ovarian reserve in ectopic pregnancies: is polycystic ovarian morphology a protective condition for ovarian reserve?
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Çetin Furkan, Bayramoglu Tepe Neslihan, Kutlar Ali Irfan
Аннотация
OBJECTIVES: The study aims to evaluate the effects of multi-dose methotrexate (MTX) or subsequent salpingectomy on ovarian reserve and explain the conditions that cause the change in serum anti-müllerian hormone (AMH) levels.
MATERIAL AND METHODS: Our department had 58 tubal ectopic pregnancy (EP) patients treated with a multiple-dose MTX protocol or subsequent salpingectomy between 2017-2020. Serum AMH level was measured in each patient before the medication and 3-6 months after therapy. Patients' details were recorded and analyzed later.
RESULTS: The mean AMH value decreased in 32 patients (-17.8%), increased in 26 patients (+31.5%) (p < 0.0001). In the group with an increase, there was a significantly high number of patients with a polycystic ovary (PCO) condition compared to the other group (p = 0.0001). The post-treatment serum AMH levels increased in patients with PCO, whereas those decreased in patients without PCO (p < 0.001).
CONCLUSIONS: Multiple-dose MTX or subsequent salpingectomy treatment in tubal ectopic pregnancy (EP) patients might not refer to significant differences in patients' AMH levels. Remarkably, post-treatment AMH levels were significantly increased in EP patients with PCO and decreased in those without this condition. PCO may be a protective condition for ovarian reserve.
MATERIAL AND METHODS: Our department had 58 tubal ectopic pregnancy (EP) patients treated with a multiple-dose MTX protocol or subsequent salpingectomy between 2017-2020. Serum AMH level was measured in each patient before the medication and 3-6 months after therapy. Patients' details were recorded and analyzed later.
RESULTS: The mean AMH value decreased in 32 patients (-17.8%), increased in 26 patients (+31.5%) (p < 0.0001). In the group with an increase, there was a significantly high number of patients with a polycystic ovary (PCO) condition compared to the other group (p = 0.0001). The post-treatment serum AMH levels increased in patients with PCO, whereas those decreased in patients without PCO (p < 0.001).
CONCLUSIONS: Multiple-dose MTX or subsequent salpingectomy treatment in tubal ectopic pregnancy (EP) patients might not refer to significant differences in patients' AMH levels. Remarkably, post-treatment AMH levels were significantly increased in EP patients with PCO and decreased in those without this condition. PCO may be a protective condition for ovarian reserve.