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Randomized Controlled Trial
. 2025 Feb;311(2):223-227.
doi: 10.1007/s00404-024-07892-6. Epub 2024 Dec 22.

Evaluating single-dose methotrexate alone versus methotrexate with letrozole for treating ectopic pregnancy: a comparative study

Metin Ayğar  1   2 , Mustafa Güven  3 , Serhat Uygur  3 , Özgür Arslan  4 , Onur Karaaslan  5 , Erbil Karaman  5
Affiliations
Randomized Controlled Trial

Evaluating single-dose methotrexate alone versus methotrexate with letrozole for treating ectopic pregnancy: a comparative study

Metin Ayğar et al. Arch Gynecol Obstet. 2025 Feb.

Erratum in

Abstract

Purpose: Ectopic 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.

Methods: Between June 2021 and September 2022, a total of 60 patients diagnosed with EP at the Faculty of Medicine, Yüzüncü Yıl 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 β-hCG levels. Secondary outcomes included the need for surgical intervention and the occurrence of side effects.

Results: Both 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 β-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.

Conclusion: Letrozole may offer a potential contribution to MTX therapy by providing a more pronounced reduction in β-hCG levels, but further research with larger sample sizes and longer follow-up periods is needed to confirm these findings.

Keywords: Ectopic pregnancy; Letrozole; Methotrexate; β-hCG.

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Conflict of interest statement

Declarations. Conflict of interests: The authors have no relevant financial or non-financial interests to disclose. Consent for publication: Patients signed informed consent regarding publishing their data. Ethical approval: Ethical approval for the study was granted by the Ethics Committee of the Academic Board at Yüzüncü Yıl University on September 20, 2021, with decision number 03. Additionally, the study was registered with ClinicalTrials.gov on July 16, 2024, under registration number NCT06504082. Informed consent: Informed consent was obtained from all individual participants included in the study.

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References

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