Successful Treatment with Intraamniotic Methotrexate Injections in
Cervical Pregnancies from IVF-ICSI Cycles

Göğsen ÖNALAN, Reside ÖNALAN, Belgin SELAM, Recai PABUÇCU
Ankara-Turkey

Cervical pregnancy is a life threatening disorder which has an incidence of 1/1000 to 1/18000 live births. Incidence of cervical pregnancy has increased recently due to use of assisted reproductive techniques for infertility. The underlying mechanisms for ectopic pregnancies in IVF cycles without absolute risks such as pelvic inflammatory disease, curettage and intrauterine device are unknown.Two cases of cervical pregnancy in IVF-ICSI cycles were treated successfully by intraamniotic injections of methotrexate in three months.Alterations in the normal contraction patterns of the uterus may result with expulsion of the embryos into the cervix during pregnancy. Slow progression of the oocytes and discordance between the embryos and the endometrium may be the etiology of abnormal uterine contractions leading to fundo-cervical contractions in the early luteal phase. The major advantages of local injections of methotrexate into the amniotic cavity are direct organ-targeted effect of both surgical procedure and medical therapy.
(Gynecol Obstet Reprod Med 2005; 11:211-214)

Key Words: Cervical pregnancy, Methotrexate, IVF-ICSI procedure