Organ-Preserving Methotrexate Treatment in Recurrent Ectopic Pregnancy: A Case Report

Objective: To assess the significance of diagnosis, treatment, and management approaches in cases of recurrent ectopic pregnancies. Material and Method: This study presents the management of a 31-year-old woman with a history of left tubal pregnancy and subsequent left salpingectomy, who presented with a right tubal ectopic pregnancy. Methotrexate (MTX) treatment was initiated due to the absence of contraindications. On the first day of MTX, the patient’s serum βhCG level was 5135.64 U/L, but it continued to rise. Subsequently, the patient received a second dose of MTX. On the fourth day of the second MTX dose, the serum βhCG level was 8333.98 U/L, while on the fifth day of the second MTX dose, the βhCG level dropped dramatically to 6819.35 U/L. Twenty-two days after the second dose of MTX treatment, the serum βhCG level was 848.76 U/L. Transvaginal ultrasound revealed a decrease in the ectopic mass. Conclusion: Early diagnosis of tubal ectopic pregnancies can be effectively managed through medical intervention, demonstrating a high success rate.