Effect of letrozol on BHCG regression in patient with ectopic pregnancy in Alzahra educational and therapeutic center, Tabriz, Iran

Abstract

Ectopic pregnancy is one of the reasons of maternal mortality and morbidity in communities. Although mortality has decreased over time with earlier diagnosis, ectopic pregnancies are still responsible for six percent of maternal deaths. Nowadays, methotrexate is one of the most widely-studied and accepted drugs for the treatment of ectopic pregnancy. Nonetheless, there are many problems with methotrexate, including side effects, contraindications, and failure to respond to treatment. The present study intends to investigate letrozole’s effect on BHCG regression in ectopic pregnancy by relying on its anti-estrogenic effect. Materials and Methods: In the present study, after obtaining informed consent, 44 patients with EPs registered with transvaginal ultrasound were studied. For this purpose, patients were randomly divided into two groups; the first group received 50 mg /m2 methotrexate and the second group received 5 mg / day letrozole. Patients in each group were compared in terms of BHCG decline from diagnosis to treatment and negative BHCG attainment, hospitalization time, side effects, and failure of treatment. Results: In similar conditions in terms of age and history of obstetrics, mean primary BHCG doesn’t have significant difference. Comparing BHCG on the first and fourth days of treatment, in groups receiving methotrexate and letrozole, an average of 32.97%, and 61.42% reduction in BHCG levels (P value = 0.1) were observed, respectively. Comparing BHCG on days 4 and 7 after drug administration, a 63.65% reduction in BHCG levels in methotrexate group and a 67.32% reduction in letrozole group (P value = 0.5) were registered. The decrease in BHCG level was not significant between the first and fourth day of treatment and between the fourth and seventh day of treatment. Altogether, in both groups, 19 of 20 patients, i.e., 95% of patients, responded to treatment. There was no significant difference between the two groups in terms of hospitalization (P value =0/3) and BHCG follow-up time (P value =0.1).