The role of early determination of beta-human chorionic gonadotropin levels in predicting the success of single-dose methotrexate treatment in ectopic pregnancy

Abstract

Objective: The aim of the study was to determine the importance of beta-hCG level on day 4 following methotrexate (MTX) administration, and the difference between beta-hCG levels assessed on day 0 and day 4 in predicting treatment success. Material and methods: A total of 68 women with tubal pregnancy, treated with a single dose of MTX, were selected for this retrospective study. Results: The success rate of single-dose MTX treatment in our clinic was 75% (51/68). Among 51 patients in whom MTX treatment was successful, 25 (36.8%) showed a decrease in beta-hCG level of > 15% on days 0 and 4, and 44 (64.7%) showed a beta-hCG level decrease of > 15% on days 4 and 7. For subjects with beta-hCG decrease of > 15% on days 4 and 7, the standard error was 6.5%, and the area under the ROC curve was 81.7%, while the corresponding values for days 0 and 4 were 7.2% and 64%, respectively. Conclusions: A decrease of > 15 % in beta-hCG levels between days 0 and 4 does not seem to be a better predictor for success of single-dose MTX treatment for ectopic pregnancy than between days 4 and 7. A statistically significant difference was observed only in beta-hCG levels on day 7 in both, successful and unsuccessful single-dose MTX groups.