Two-Dose Methotrexate for Ectopic Pregnancy

Inclusion Criteria: * Confirmed diagnosis of ectopic pregnancy via * D\&E without products of conception identified on frozen pathology or * VABRA without products of conception identified with pathologic evaluation or * Ultrasound visualization of a gestational sac in the adnexa, with definitive visualization of a yolk sac or fetal pole * the subject is hemodynamically stable without signs of hemoperitoneum * laparoscopy has not been performed * the subject is able to return for frequent follow-up care * normal renal and liver function have been documented within 2 days * normal white blood count and platelet count have been documented as per laboratory standard * normal chest x-ray was obtained if the subject has a history of pulmonary disease * no history of allergy or sensitivity to methotrexate or any component of its formulation Exclusion Criteria: * breastfeeding * laboratory evidence of immunodeficiency * alcoholism or chronic liver disease * the concomitant use of non-steroidal anti-inflammatory drugs * blood dyscrasia such as leukopenia, thrombocytopenia, or severe anemia * active pulmonary disease * hepatic, renal, or hematological dysfunction * adnexal mass \> or = 3.5 cm * presence of fetal cardiac motion * active major psychiatric disorder such as major depression, bipolar disease, psychotic disorder, or drug addiction * subjects unable or unwilling to comply with study procedures or illiterate