Ectopic pregnancy

Why should medical treatment with methotrexate not be an option here?Is it because the beta hcg values have not been mentioned?

Ive no idea why my pasted print screen does not appear when I post the question.Anyways,the question was:

An asymptomatic 30 year old woman with a previous ectopic pregnancy presents at 6 weeks amenorrhoea for trans-vaginal scan to exclude a repeat ectopic pregnancy. Her pregnancy test had been positive 2 weeks earlier. The scan is reported to show a 14mm endometrium with no gestation sac. There is a 4cm cystic structure in the right adnexum suggestive of an ectopic pregnancy but no free fluid in the pouch of Douglas

The options included laparoscopy and medical management with methotrexate.