Objectives: To evaluate the efficacy of treatment with methotrexate, and the possibility of medical treatment of living embryo.

Observation: We report two cases in secondary amenorrhea of 6 weeks received in an algebra table associated with minimal bleeding.

The physical examination had found moderate pain in the left iliac fossa for the first patient and for the second patient in the right iliac fossa with minimal bleeding. The first endo-vaginal ultrasound showed a left lateral uterine mass, the second one a right lateral uterine mass containing a living embryo of six- week amenorrhea. We administered a triple dose of methotrexate to both patients whose improvement could be noticed trough a clinical remission and a decrease of the plasmatic βHCG level. Consequently, we decided to release them after 8 days of hospitalization.

Conclusion: The medical treatment of tubal ectopic pregnancy with living embryo is difficult due to the work conditions; furthermore, it is a controversial issue in our country.