Effect of methotrexate exposure on subsequent fertility in women undergoing controlled ovarian stimulation  

Oleh:

McLaren, Janet F. ; Burney, Richard O. ; Milki, Amin A. ; Westphal, Lynn M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 92 no. 02 (Aug. 2009), page 515-519.
Topik: Methotrexate; chemotherapy; fertility; in vitro fertilization; ovarian response; endometrial thickness

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2009.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

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.

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