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Relationship between endometrial thickness and beta-HCG levels in the response to treatment of ectopic pregnancy with methotrexate

OBJECTIVE: to evaluate the correlation between the beta-human chorionic gonadotropin (beta-hCG) serum levels and the measurement of the endometrial thickness, in patients under treatment of ectopic pregnancy with methotrexate. METHODS: a prospective study in which the levels of beta-hCG as well as the largest measurement of the endometrial thickness on the uterine longitudinal axis through transvaginal ultrasound were evaluated at 24-48 h intervals in thirty-eight patients with hemodynamic stability, ectopic pregnancy, diameter <3.5 cm, and increased beta-hCG levels. All the patients got methotrexate in a single-dose therapy (50 mg/m² im). We compared the mean values of beta-hCG and endometrial thickness of cases that evolved successfully versus the poor responders using the Student t-test. Afterwards we analyzed the difference of the beta-hCG mean serum values related to the endometrial thickness(<10.0 mm and >10.0 mm) independently of the response to treatment employing the Student t-test. RESULTS: the mean values of beta-hCG and endometrial thickness in patients with successful treatment (28 cases) were 1936.2 mIU/ml and 6.4 mm, respectively, significanlty lower than the mean values for insuccessful cases: 6831.3 mIU/ml and 11.7 mm, respectively (p<0.05). The mean values of beta-hCG in women with endometrial thickness <10.0 mm were 2008.7 mIU/ml, significantly lower than the ones with endometrium >10.0 mm, whose mean values were 6925.9 mIU/ml (<0.05). CONCLUSIONS: the measurement of the endometrial thickness through ultrasound is under the beta-hCG serum values influence, and it showed to be a valuable additional factor to suggest medical treatment with methotrexate in the non-disrupted ectopic pregnancy.

Ectopic pregnancy; Endometrium; Chorionic gonadotropin


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