Corpus luteum activity was monitored in 15 women undergoing nonsurgical management of ectopic pregnancy with local methotrexate injection followed by alternating oral methotrexate and citrovorum factor (group A, n = 8) or local methotrexate injection alone (group B, n = 7). All patients initially demonstrated a viable corpus luteum (plasma progersterone ranged from 1.4 to 19 ng/ml). The treatment was successful in 14, with the exception of one whose tube ruptured 11 days after local administration of methotrexate, despite a continuous decrease in Β human chorionic gonadotropin, 17Β-estradiol and plasma progesterone levels. There seems to be no correlation between the success of the treatment and the behavior of Β human chorionic gonadotropin, 17Β-estradiol and plasma progesterone. Three patients from group A and two from group B displayed an initial rise in Β human chorionic gonadotropin following the initiation of the therapy, but the corpus luteum response differed. In group B patients, 17Β-estradiol and plasma progesterone levels increased in parallel with Β human chorionic gonadotropin. Group A patients displayed a continuous decrease in 17Β-estradiol and plasma progesterone levels despite the elevation of Β human chorionic gonadotropin, suggesting a possible effect of the systemic methotrexate on corpus luteum activity.

Keywords:
Corpus luteum, Ectopic pregnancy, Methotrexate therapy
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© 1992 S. Karger AG, Basel
1992
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