Question
If you get pregnant while taking methotreate, will I abort it?
Answer
A review article by M.E. Lloyd et al (QJ Med 1999; 92:551-563) titled “The effects of methotrexate on pregnancy, fertility and lactation” concluded the following about MTX and pregnancy:
1.MTX demonstrates significant teratogenicity. Skull and limb abnormalities are most frequent. The effects are unpredictable, making counselling difficult in individual cases.
2.In cases of MTX exposure, the drug should be stopped and women wishing to continue the pregnancy should, following counselling, be offered treatment with folinic acid for at least 5 months in order to minimize MTX effects on the fetus.
3. Women should be warned that there may be a small increased risk of spontaneous abortion early in pregnancy, and advised against taking MTX if they are considering conception. Those who choose to stop MTX and proceed to pregnancy should be advised against conception within 6 months of taking MTX. In the event of conception within this time, full counselling and close fetal monitoring should be offered.
