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hCG levels after 2nd methotrexate injection

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Sunny21
Posts: 2
Joined: Wed Sep 08, 2021 9:19 am

hCG levels after 2nd methotrexate injection

Post by Sunny21 »

I have received my 2nd methotrexate injection for an ectopic pregnancy. Initially my levels didn't fall between day 4 and day 7 but after doing another hCG level on day 9 they started falling so my 2nd shot was postponed. I was then told after yet another hCG on day 11 and 13 that while my levels had dropped, that they weren't going down fast enough and was given a 2nd shot. Overall from day 4 to day 13 they had dropped by 34% and I am just wondering does anyone know what kind of drop rate is acceptable after the 2nd shot? Anything I have looked up just refers to the 15% drop between day 4 and day 7 on the first injection. I am a bit concerned that they will now suggest surgery if certain hCG targets aren't met. My level at time of the 2nd injection was 1200. Has anyone else had a similar experience where the 2nd shot was successful and at what rate the doctor expected levels to decrease?

EPT Host 20
Posts: 2375
Joined: Thu May 31, 2012 9:58 pm

Re: hCG levels after 2nd methotrexate injection

Post by EPT Host 20 »

Dear Sunny,
I am so sorry to hear of your ectopic pregnancy and loss,
Your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven.
I am afraid it is difficult to predict how long it will take for your hormone levels reach non-pregnant levels and how quickly it happens. As we are all individual, our bodies respond differently to the drug and it depends on factors like how high levels reached and our unique physiology. What I can say is that it can take a number of weeks and, while it can take some time, it is not as invasive a procedure as surgery. It is also encouraging that your levels are falling steadily although I appreciate that it can be a drawn out process. Also, in terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).

Sending much love,
Karen x

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vanessa5643
Posts: 1
Joined: Tue Sep 21, 2021 1:15 am

Re: hCG levels after 2nd methotrexate injection

Post by vanessa5643 »

Hi Sunny,

Four days ago I received my 2nd dose of MTX. My HCG levels were not dropping fast enough so I had to get a second shot. Today my levels hav e decreased from 900 to 600 (since last Friday). I will get my HCG levels tested again on Thursday and hope they continue to go down so I do not have to consider surgery.

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