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Background: It remains unclear which methotrexate protocol for the treatment of ectopic pregnancy has a higher success rate or a higher adverse effect rate., Objective: To compare the treatment success rates and adverse effect rates of single-dose and non-single-dose (two-dose and multi-dose) methotrexate protocols in the treatment of ectopic pregnancy., Search Strategy: Various databases including Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched on July 1, 2017, using search terms including "methotrexate" and "pregnancy.", Selection Criteria: Randomized controlled trials comparing different methotrexate protocols for the treatment of ectopic pregnancy were included., Data Collection and Analysis: Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to compare treatment success rates and adverse effect rates., Main Results: The single-dose and non-single-dose protocols had similar success rates (RR 1.00, 95% CI 0.96-1.04; 11 trials, 1121 patients, I 2 =18%). The non-single-dose protocols had a higher adverse effect rate than did the single-dose protocol (RR 0.73, 95% CI 0.59-0.91; nine trials, 934 patients, I 2 =0%)., Conclusions: The single-dose methotrexate protocol was the optimal protocol for the medical treatment of ectopic pregnancy., (© 2018 International Federation of Gynecology and Obstetrics.)

We present a case report of an ovarian pregnancy after ipsilateral partial salpingectomy. A 19-year-old woman was admitted with vaginal bleeding and right lower abdominal pain. She had a history of right partial salpingectomy caused by a tubal pregnancy. The pregnancy test result was positive, and a right adnexal mass was identified by ultrasonography. Laparoscopy revealed a right ovarian pregnancy. Thus the possibility of ipsilateral ectopic pregnancy should be considered even when the patient has a history of salpingectomy total or partial., (Copyright 2010 AAGL. Published by Elsevier Inc. All rights reserved.)

A 35-year-old woman with a history of myomectomy underwent in vitro fertilization and became pregnant. Transvaginal ultrasound revealed a gestational sac within the subserosal area of the posterior uterine wall. The patient was treated successfully with conservative surgery, and the pathologic evaluation of the excised mass demonstrated chorionic villi involving myometrium. Early in a subsequent pregnancy, placental invasion through the sinus tract was detected. However, the pregnancy outcome was uneventful. This constitutes the first report of subserosal implantation in the uterine body. Our findings suggest that the probable pathogenesis of this rare variant of intramural pregnancy is implantation through a sinus tract made during a previous uterine surgery.