I was 5,5 weeks when I started having strong pain on the left side of my stomach, my back and also my left leg down to the knee and well as some bleeding. I had to go to the emergency room, but they could not confirm any miscarriage. 3-4 days and several blood tests after, my HCG level started raising after dropping, and confirmed that I had an ectopic pregnancy. Since my HCG level was only around 3-400, the doctor decided to give me methotrexate. I had to wait one week before I took a new blood test, and that week was the most painful week I’ve ever had. I had extreme pains on my left side. When the time came, they took a new blood test, and I was informed that my HCG level had not dropped as much as they expected (they expect it to drop 15 %, mine dropped only 12 %). So the doctor called from the hospital and asked me to come over so that she could give me one more dosage of methotrexate. When I told her how much pain and bleeding I have had the last few days, she changed her mind. She took an ultrasound and observed that my tube had started cracking and there was blood in my abdominal area. So she sent me to get an operation and remove the tube. After the operation, I had no more pain and I feel so relieved that everything went fine. Although I had a very tough month with loads of pain and bad news, I now 2,5 weeks after my operation feel much better. Today I got my blood test results and my HCG is finally at zero (negative).
Now I am thinking about the future. How long does it take to get the period back after your HCG level drops to 0? And is it recommended to get the other tube checked before trying to get pregnant again? In that case, what kind of check up can I do? I have also read that you should wait 2-3 months before trying again after an methotrexate / surgery. I have had both – do I have to wait longer?
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I had both methotrexate and surgery - what to expect now?
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Re: I had both methotrexate and surgery - what to expect now
Dear zmc88,
I am so sorry to hear of your ectopic pregnancy and loss, and the stressful time you have been through.
Experiencing an ectopic pregnancy is a huge ordeal and you are in the early stages of recovery. Your body needs time to heal from your surgery which is in itself a gruelling task. You have also had to process the loss of your baby and been through an immense rollercoaster of emotions - all of this will take time to come to terms with.
You should take it very easily for about six weeks after surgery. Your body will be using its energies to heal internally. It is normal to feel physically and emotionally exhausted during this time and please do be kind to yourself. Recovery can take time and some days will be better than others, one day you maybe ok and the next you maybe in discomfort or more emotional. This is perfectly usual and the healing process will go back and forth in this way for however long you need. It is important to listen to your body's signals and pain and feeling tired are your body's signs to tell you to rest. We suggest keeping a healthy balanced diet, drinking lots of water and resting. Once your wounds have healed, very gentle exercise such as a short walk can help, but please do take this slowly.
Your periods can take a while to re-establish - they can re-start anything between two and ten weeks after surgery and most women find that their period arrives sometime around week six or seven after surgery.
The first period may be more painful or less so than usual, heavier or lighter, last for longer or shorter than usual – there really is no set pattern. You should be able to manage the discomfort with over-the-counter pain relief and should not be soaking a pad in less than an hour. If this is not the case, you should seek medical attention
In the UK, it is not routine practice to check the remaining tube post surgery,
We have more information on trying to conceive after ectopic pregnancy here- https://ectopic.org.uk/patients/trying-to-conceive/
The chances of a further ectopic after a first in UK is 10%. So that's 90% chance of the embryo being in right place next time.
While generally it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years. Importantly early scans avail. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.
You do not need to wait longer before trying to conceive because you have had methotrexate and surgery, but you do need to follow advice regarding trying to conceive following methotrexate. As your hCG levels have fallen to below 5mIU/mL, we advise that you take a folic acid supplement for 12 weeks before you try to conceive. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the "wait" and then taking folic acid for 12 weeks before trying to conceive is so important.
Please be kind to yourself and allow time to grieve, to heal both physically and emotionally. We will be here for you for as long as you need.
Sending much love and warm hugs,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
**************************************************************************
If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?
Further information is available at ectopic.org.uk
Email us: ept@ectopic.org.uk
We provide a call-back helpline service: 020 7733 2653
The latest EPT newsletter is out now! You can take a look at the Winter edition and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
***************************************************************************
I am so sorry to hear of your ectopic pregnancy and loss, and the stressful time you have been through.
Experiencing an ectopic pregnancy is a huge ordeal and you are in the early stages of recovery. Your body needs time to heal from your surgery which is in itself a gruelling task. You have also had to process the loss of your baby and been through an immense rollercoaster of emotions - all of this will take time to come to terms with.
You should take it very easily for about six weeks after surgery. Your body will be using its energies to heal internally. It is normal to feel physically and emotionally exhausted during this time and please do be kind to yourself. Recovery can take time and some days will be better than others, one day you maybe ok and the next you maybe in discomfort or more emotional. This is perfectly usual and the healing process will go back and forth in this way for however long you need. It is important to listen to your body's signals and pain and feeling tired are your body's signs to tell you to rest. We suggest keeping a healthy balanced diet, drinking lots of water and resting. Once your wounds have healed, very gentle exercise such as a short walk can help, but please do take this slowly.
Your periods can take a while to re-establish - they can re-start anything between two and ten weeks after surgery and most women find that their period arrives sometime around week six or seven after surgery.
The first period may be more painful or less so than usual, heavier or lighter, last for longer or shorter than usual – there really is no set pattern. You should be able to manage the discomfort with over-the-counter pain relief and should not be soaking a pad in less than an hour. If this is not the case, you should seek medical attention
In the UK, it is not routine practice to check the remaining tube post surgery,
We have more information on trying to conceive after ectopic pregnancy here- https://ectopic.org.uk/patients/trying-to-conceive/
The chances of a further ectopic after a first in UK is 10%. So that's 90% chance of the embryo being in right place next time.
While generally it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years. Importantly early scans avail. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.
You do not need to wait longer before trying to conceive because you have had methotrexate and surgery, but you do need to follow advice regarding trying to conceive following methotrexate. As your hCG levels have fallen to below 5mIU/mL, we advise that you take a folic acid supplement for 12 weeks before you try to conceive. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the "wait" and then taking folic acid for 12 weeks before trying to conceive is so important.
Please be kind to yourself and allow time to grieve, to heal both physically and emotionally. We will be here for you for as long as you need.
Sending much love and warm hugs,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
**************************************************************************
If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?
Further information is available at ectopic.org.uk
Email us: ept@ectopic.org.uk
We provide a call-back helpline service: 020 7733 2653
The latest EPT newsletter is out now! You can take a look at the Winter edition and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
***************************************************************************
