Evaluating Single-Dose Methotrexate Alone Versus Methotrexate With Letrozole for Treating Ectopic Pregnancy: a Comparative Study

Abstract

PurposeEctopic pregnancy (EP) constitutes 1-2% of all pregnancies. Methotrexate (MTX) is commonly used in treating EP, but it has some limitations and potential side effects. Clinical studies have shown that letrozole, an aromatase inhibitor, may potentially be used in conjunction with MTX therapy. In our study, we explored the efficacy of adding letrozole to MTX in managing EP.MethodsBetween June 2021 and September 2022, a total of 60 patients diagnosed with EP at the Faculty of Medicine, Y & uuml;z & uuml;nc & uuml; Y & imath;l University, were randomly divided into two groups. Group 1 received MTX alone, while Group 2 received a combination of MTX and letrozole. The primary outcome measure was the change in serum beta-hCG levels. Secondary outcomes included the need for surgical intervention and the occurrence of side effects.ResultsBoth groups demonstrated similar success rates in treatment, and there was no significant difference between the MTX and MTX + letrozole groups regarding the need for surgical intervention. Although beta-hCG levels declined more rapidly in the MTX + letrozole group, these decreases were not statistically significant. The combination of MTX and letrozole in the treatment of ectopic pregnancy has shown similar efficacy to single-dose MTX.ConclusionLetrozole may offer a potential contribution to MTX therapy by providing a more pronounced reduction in beta-hCG levels, but further research with larger sample sizes and longer follow-up periods is needed to confirm these findings.