Sequential Letrozole and Methotrexate Therapy Safely improved the outcomes of Medical treatment of Tubal Ectopic Pregnancy

Background: Surgical management is curative for tubal ectopic pregnancy (TEP), but multiple studies documented the safety and efficacy of single-dose methotrexate (SD-MTX) as a medical treatment. Objectives: Evaluation of the success rate (SR) of letrozole (LTZ; 5 mg/day) for 4-day versus SD-MTX (50 mg/m2) as medical treatment of TEP as judged by the rate of shift-to-surgery. Patients and Methods: Serum βhCG levels were estimated on D1, 4, 7, 11 and 18 of start of therapies and the extent of change (Δ βhCG) was calculated concerning D-1 levels. For patients of LTZ group, if Δ1-4 βhCG was >10% LTZ therapy was continued, but if it was