I was in a similar situation, and methotrexate was pushed as an option, however, I sought a second opinion.
The second opinion, a Fertility Specialist, said that using methotrexate went against the Hippocratic Oath in this situation — “First, do no harm.”
In my case, the specialist was skilled in removing the perished embryo from my ruptured fallopian tube, then he patched the tube, preserving the tube and increasing the chance for successful implantation in the future.
I conceived several months after this procedure. Had I followed the course of methotrexate, there is a longer wait period to try having another child, with undetermined long-term risks with using a chemotherapeutic agent, such as methotrexate.
Skill in patching and preserving my fallopian tube was key, and I recommend always seeking a second opinion from the best in the field, when possible.