CCoPE
Date: 2001-12-17

Question:
Dear Motherisk: I had the pleasure of speaking with Amy this morning. She recommended that I ask my question(s) here... To be brief... what are the known dangers or risks, if any, to my daughter who is 8, of future fertility or other problems. She takes Methotrexate each Saturday for JRArthritis. Aprox. 18mg. for the past year. She is supposed to be taking this medicine for aprox. the next 4 years. This question was brought to my attention after losing our baby daughter 2 weeks ago... she had a Complex Congenital Heart Malformation... Atrioventricular Canal Defect as well as Tetralogy of Fallot... is there any possible relation? We give (our daughter) her medicine in pill form @ home.

Answer:
The following information should not replace the assessment and advice you have been receiving from your physician (cancer specialist, obstetrician, or any other healthcare provider). It is offered for your information only

For your daughter: According to the Physicians' Desk Reference, methotrexate has been reported to cause impairment of fertility during and for a short time after therapy. However, studies have shown that low dose methotrexate (that used to treat arthritis) has not been found to adversely affect female fertility.

For your previous pregnancies: It is unlikely that administering methotrexate in tablet form to your daughter while pregnant would increase your risk for having a baby with a congenital abnormality. The amount that would have been absorbed systemically (into your blood stream) is minimal, so the amount getting to your developing baby would have been negligible. There have been no reports of Atrioventricular Canal Defect and Tetralogy of Fallot being associated with methotrexate intake during pregnancy.