Evaluation of the parameters in predicting single‐dose methotrexate therapy success for ectopic pregnancy

Aim Methotrexate has demonstrated efficacy in treating ectopic pregnancies. This study explores factors influencing treatment success, focusing on laboratory and ultrasonographic findings, particularly the day 4 to day 1 β‐hCG level ratio. Methods Retrospective cohort study was conducted within patients diagnosed with tubal ectopic pregnancy. Patients' characteristics, ultrasound findings, laboratory data, and β‐hCG levels (days 1, 4, 7), and operation findings were reviewed. Women's characteristics were investigated who were treated with single dose of MTX (50 mg/m2). Patients who were performed surgery after MTX treatment were identified as MTX treatment failure. Results Among 439 women, 259 underwent surgery due to acute symptoms. Of those treated with MTX, 143 experienced treatment success, while 37 underwent surgery after MTX (MTX failure). Comparative analysis revealed significant differences in β‐hCG levels on admission (1128 and 4125 mIU/mL) and the day 4 to day 1 β‐hCG ratio (0.91 and 1.25). The overall MTX success rate was 79%, reaching 93% and 89% for β‐hCG levels