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Methotrexate

Selected References:

  • American College of Obstetricians and Gynecologists. 2018. Tubal ectopic pregnancy. ACOG Practice Bulletin No. 193. Obstet Gynecol 131:e9—e103.
  • Del Campo M, et al. 1999. Developmental delay in fetal aminopterin/methotrexate syndrome. Teratology 60:10-12.
  • Donnenfield AE, et al. 1994. Methotrexate exposure prior to and during pregnancy. Teratology 49:79-81.
  • Eck, LK, et al. 2017. Risk of adverse pregnancy outcome after paternal exposure to methotrexate within 90 days before pregnancy. Obstet Gynecol 129(4):707-714.
  • Ersoy GS, et al. 2016. Comparison of the long-term effects of single-dose methotrexate and salpingectomy on ovarian reserve in terms of anti-müllerian hormone levels. Human Fertility 19(4):262-267.
  • Feldkamp M, Carey JC. 1993. Clinical teratology counseling and consultation case report: low dose methotrexate exposure in the early weeks of pregnancy. Teratology; 47:533-439.
  • French AE, et al. 2003. Effect of methotrexate on male fertility. Can Fam Physician 49:577-578.
  • Friedman S, et al. 2017. Paternal use of azathioprine/6-mercaptopurine or methotrexate within 3 months before conception and long-term health outcomes in the offspring-A nationwide cohort study. Reprod Toxicol 73:196-200.
  • Hoeltzenbein M, et al. 2008. Paternal exposure to drugs—is there an increased risk for congenital abnormalities?: Experience of the Berlin Institute for Clinical Teratology and Drug Risk Assessment during Pregnancy. Reprod Toxicol 26: 64 [abstract].
  • Hyoun SC, Običan SG, Scialli AR. 2012. Teratogen update: methotrexate. Birth Defects Res A Clin Mol Teratol, 94(4):187-207.
  • Jordan RL, et al. 1976. Embryotoxicity of the folate antagonist methotrexate in rats and rabbits. Teratology 15:73-80.
  • Kozlowski RD, et al. 1990. Outcome of first-trimester to low-dose methotrexate in eight patients with rheumatic disease. Am J Med 88(6):589-592.
  • Lee CY et al. 2010. A pilot study of paternal drug exposure: the Motherisk experience. Reprod Toxicol. 29(3):353-60.
  • Lloyd ME, et al. 1999. The effects of methotrexate on pregnancy, fertility and lactation. Q J Med 92:551-563
  • Martin M.C., Barbero P., Groisman B., Aguirre M.A., Koren G. 2014. Methotrexate embryopathy after exposure to low weekly doses in early pregnancy. Reprod Toxicol, 43: 26-29.
  • Martínez Lopez JA, et al. 2009. Systematic review on the safety of methotrexate in rheumatoid arthritis regarding the reproductive system (fertility, pregnancy and breastfeeding). Clin Exp Rheumatol 27:678-684.
  • McLaren JF, et al. 2009. Effect of methotrexate exposure on subsequent fertility in women undergoing controlled ovarian stimulation. Fertil Steril 92(2):515-519.
  • Methorexate Drug Label, 2020: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/040054s015,s016,s017.pdf.
  • Nagafuchi H, et al. 2022. Pregnancy outcomes in patients with rheumatoid arthritis who discontinue methotrexate treatment to conceive. Clin Rheumatol; 41(3):669-675.
  • Nguyen GC, et al. 2016. The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy. Gastroenterology 150(3):734-757.
  • Ostensen M, et al. 2009. Management of RA medications in pregnant patients. Nat Rev Rheumatol 5(7):382-390.
  • Wentzell N, et al.2022. Use of Methotrexate in Girls and Women of Childbearing Age, Occurrence of Methotrexate-Exposed Pregnancies and Their Outcomes in Germany: A Claims Data Analysis. Clin Drug Investig. 2023 Feb;43(2):109-117.
  • Zanetti A, et al. 2022. Impact of rheumatoid arthritis and methotrexate on pregnancy outcomes: retrospective cohort study of the Italian Society for Rheumatology. RMD Open; 8(2):e002412.

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