{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:05:32Z","timestamp":1791821132796,"version":"4.3.4"},"reference-count":5,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["raf.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5,30]]},"abstract":"<jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p>\n                      <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"images\/RAF-23-0019inline1.jpeg\"\/>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay summary<\/jats:title>\n                    <jats:p>An ectopic pregnancy occurs when an embryo implants outside of the uterus, usually in a fallopian tube. When detected early, treatment is often with a medication called methotrexate. When methotrexate does not work, surgery is required. A recent clinical trial of ectopic pregnancy treatment (called GEM3) found that adding a drug called gefitinib to methotrexate did not reduce the need for surgery. We have used data from the GEM3 trial, combined with data collected 12 months after the trial finished, to investigate post-methotrexate pregnancy outcomes. We found no difference in pregnancy rates, pregnancy loss rates and recurrent ectopic pregnancy rates between those treated medically only and those who subsequently also needed surgery. The surgical technique used also did not affect pregnancy rates. This research provides reassurance that women with ectopic pregnancies treated medically who need surgery have similar post-treatment pregnancy outcomes to those treated successfully medically.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/raf-23-0019","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T12:27:05Z","timestamp":1685449625000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-13","source":"Crossref","is-referenced-by-count":6,"title":["Subsequent pregnancy outcomes among women with tubal ectopic pregnancy treated with methotrexate"],"prefix":"10.1530","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5823-4334","authenticated-orcid":true,"given":"Scott C","family":"Mackenzie","sequence":"first","affiliation":[{"name":"MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0473-0532","authenticated-orcid":true,"given":"Catherine A","family":"Moakes","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-5740","authenticated-orcid":true,"given":"W Colin","family":"Duncan","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2319-0586","authenticated-orcid":true,"given":"Stephen","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9656-493X","authenticated-orcid":true,"given":"Andrew W","family":"Horne","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Fertility and Sterility","first-page":"1271","article-title":"Fertility after tubal ectopic pregnancy: results of a population-based study","volume":"98","author":"de Bennetot","year":"2012","unstructured":"de Bennetot MRabischong BAublet-Cuvelier BBelard FFernandez HBouyer JCanis M & Pouly JL 2012Fertility after tubal ectopic pregnancy: results of a population-based study. Fertility and Sterility981271\u20136.e1. (https:\/\/doi.org\/10.1016\/j.fertnstert.2012.06.041)"},{"key":"bib2","series-title":"Human Reproduction","first-page":"1247","article-title":"Fertility after ectopic pregnancy: the DEMETER randomized trial","volume":"28","author":"Fernandez","year":"2013","unstructured":"Fernandez HCapmas PLucot JPResch BPanel PBouyer J & GROG 2013Fertility after ectopic pregnancy: the DEMETER randomized trial. Human Reproduction281247\u20131253. (https:\/\/doi.org\/10.1093\/humrep\/det037)"},{"key":"bib3","series-title":"Lancet","first-page":"655","article-title":"Combination of gefitinib and methotrexate to treat tubal ectopic pregnancy (GEM3): a multicentre, randomised, double-blind, placebo-controlled trial","volume":"401","author":"Horne","year":"2023","unstructured":"Horne AWTong SMoakes CAMiddleton LJDuncan WCMol BWWhitaker LHRJurkovic DCoomarasamy ANunes N,  2023Combination of gefitinib and methotrexate to treat tubal ectopic pregnancy (GEM3): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet401655\u2013663. (https:\/\/doi.org\/10.1016\/S0140-6736(2202478-3)"},{"key":"bib4","article-title":"Ectopic pregnancy: scenario: follow up after an ectopic pregnancy 2021","unstructured":"National Institute for Health and Care Excellence (NICE)Ectopic pregnancy: scenario: follow up after an ectopic pregnancy 2021. Available at: https:\/\/cks.nice.org.uk\/topics\/ectopic-pregnancy\/management\/follow-up-after-an-ectopic-pregnancy\/ (Accessed Mar 15th 2023)."},{"key":"bib5","series-title":"European Journal of Obstetrics, Gynecology, and Reproductive Biology","first-page":"192","article-title":"Subsequent pregnancy outcome of tubal ectopic pregnancies treated by methotrexate and salpingectomy","volume":"212","author":"Park","year":"2017","unstructured":"Park EHGMohammadi-Zaniani GPronin SElderfield CHJ & Duncan WC 2017Subsequent pregnancy outcome of tubal ectopic pregnancies treated by methotrexate and salpingectomy. European Journal of Obstetrics, Gynecology, and Reproductive Biology212192\u2013193. (https:\/\/doi.org\/10.1016\/j.ejogrb.2017.02.018)"}],"container-title":["Reproduction and Fertility"],"original-title":[],"link":[{"URL":"https:\/\/raf.bioscientifica.com\/view\/journals\/raf\/4\/2\/RAF-23-0019.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/raf.bioscientifica.com\/downloadpdf\/journals\/raf\/4\/2\/RAF-23-0019.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/raf.bioscientifica.com\/downloadpdf\/journals\/raf\/4\/2\/RAF-23-0019.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:53:52Z","timestamp":1784555632000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/raf\/article\/26236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":5,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/raf-23-0019","relation":{},"ISSN":["2633-8386"],"issn-type":[{"value":"2633-8386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,1]]}}}