A New Hormonal Treatment for Ectopic Pregnancy: Letrozole Is as Effective as Methotrexate

HIGHLIGHTS FROM THE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE’S 2019 SCIENTIFIC CONGRESS & EXPO
16
Oct

A New Hormonal Treatment for Ectopic Pregnancy: Letrozole Is as Effective as Methotrexate

Philadelphia, PA—Today, at the American Society for Reproductive Medicine’s 77th Scientific Congress and Expo, US and Egyptian researchers presented a prospective cohort study showing for the first time that letrozole, an aromatase inhibitor, is as effective as methotrexate as a medical treatment to end ectopic pregnancy.

Forty-two patients with undisturbed ectopic pregnancy were counseled on options for treatment and divided into three treatment groups of 14 patients each: a surgical treatment (control) group, a methotrexate (study) group and a letrozole (study) group. In each of the medication study groups, 12 patients (86%) had complete resolution of their ectopic pregnancy. Two patients in each study group, however, had to go back for surgery to resolve their ectopic pregnancies.

The researchers also measured metabolic and hormonal effects of the two drugs. Treatment with methotrexate was associated with significantly higher levels of liver enzymes and lower levels of platelets. And more favorable hormone profiles were observed in the patients who received letrozole. Their levels of the pregnancy hormone HCG declined more rapidly than hCG levels in the methotrexate group.  Three months after treatment, anti-Mullerian hormone levels were lower in the methotrexate group than they were in the letrozole or surgery groups.

Bradley Hurst, MD, President of the Society for Reproductive Endocrinology and Infertility remarked,” This small study, while preliminary, shows the great promise letrozole holds for the treatment of ectopic pregnancy. Methotrexate has been a medical alternative to surgery for some time. But as an antimetabolite and immune suppressant chemotherapeutic drug, methotrexate comes with toxic effects that may threaten a patient’s health and future fertility.  Further research is needed, but based on this study, letrozole appears a safe and effective alternative.”

O-194 Mitwally et al, “The Aromatase Inhibitor, Letrozole: A Novel Treatment for Ectopic Pregnancy”

ASRM is a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers. The Society is committed to facilitating and sponsoring educational activities for the lay public and continuing medical education activities for professionals who are engaged in the practice of and research in reproductive medicine. www.asrm.org