Are early human chorionic gonadotropin levels after methotrexate therapy a predictor of response in ectopic pregnancy?

OBJECTIVE: The purpose of this study was to evaluate beta-human chorionic gonadotropin (beta-hCG) levels between days 0 and 4 as a predictor of methotrexate therapy success for ectopic pregnancy. STUDY DESIGN: We conducted a retrospective study that evaluated posttreatment beta-hCG levels of 30 patients with ectopic pregnancy who had been treated with single-dose methotrexate therapy. RESULTS: beta-hCG levels decreased between days 0 and 4 in 40.0% of cases, and 100% of these cases had treatment success. beta-hCG levels increased in 60.0% of cases, and 61.8% of these cases had treatment success. In patients with increasing beta-hCG levels on day 4, we calculated the beta-hCG "difference variable" (beta-hCG level at day 4 minus day 0). The median beta-hCG difference variable between cases of treatment success and failure were statistically significant (P = .035). CONCLUSION: beta-hCG level changes between days 0 and 4 after methotrexate therapy have clinical significance and predictive value. Decreasing beta-hCG levels is highly predictive of treatment success. The beta-hCG difference variable is a reliable predictor of success in cases with rising beta-hCG levels after methotrexate therapy.