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Are early human chorionic gonadotropin levels after methotrexate therapy a predictor of response in ectopic pregnancy?

      Objective

      The purpose of this study was to evaluate beta–human chorionic gonadotropin (β-hCG) levels between days 0 and 4 as a predictor of methotrexate therapy success for ectopic pregnancy.

      Study Design

      We conducted a retrospective study that evaluated posttreatment β-hCG levels of 30 patients with ectopic pregnancy who had been treated with single-dose methotrexate therapy.

      Results

      β-hCG levels decreased between days 0 and 4 in 40.0% of cases, and 100% of these cases had treatment success. β-hCG levels increased in 60.0% of cases, and 61.8% of these cases had treatment success. In patients with increasing β-hCG levels on day 4, we calculated the β-hCG “difference variable” (β-hCG level at day 4 minus day 0). The median β-hCG difference variable between cases of treatment success and failure were statistically significant (P = .035).

      Conclusion

      β-hCG level changes between days 0 and 4 after methotrexate therapy have clinical significance and predictive value. Decreasing β-hCG levels is highly predictive of treatment success. The β-hCG difference variable is a reliable predictor of success in cases with rising β-hCG levels after methotrexate therapy.

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