Methotrexate therapy though cheaper requires serial beta HCG monitoring and ultrasound examination with monitoring Liver function test. Along with it Leucovorin injection is given if multiple doses of Mtx are required. Sometimes it doesn't work and then you require surgery. Basically for early unruptured tubal pregnancy with less than 4 cms and B HCG less than 4000 it's good. And no cardiac activity. But if it's ruptured tube and bleeding inside, it's life threatening and one requires surgery for sure.