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Ovulation after methotrexate

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Cammy
Posts: 2
Joined: Tue Mar 09, 2021 3:49 pm

Ovulation after methotrexate

Post by Cammy »

Hi everyone,

I was wondering if you might be able to help me. I had an ectopic pregnancy at the end of January, treated with methotrexate. I never really had many side effects from methotrexate and my HCG reached 0 3 weeks later. That was almost 6 weeks ago and I haven’t ovulated yet. I understand that it can take a while for ovulation/periods to start up again. However, every 2 weeks (to the day), when I feel as though I’m due to ovulate (due to BBT) I will have some light spotting for 3-4 days. I’ve never experienced this before and have always had regular cycles. It’s as though my body is gearing up to ovulate but failing. This has happened 3 times now.

I was wondering if anyone knows what might be happening or can advise me about when I need to see my gp. I’m not pregnant.

Thank you :)

EPT Host 20
Posts: 3155
Joined: Thu May 31, 2012 10:58 pm

Re: Ovulation after methotrexate

Post by EPT Host 20 »

Dear Cammy,
I am so sorry to hear of your ectopic pregnancy and loss,
It is normal for some women report bleeding and spotting for up to six weeks after treatment for ectopic pregnancy.
Your periods can take a while to re-establish and they can re-start anything between two and ten weeks after treatment. Most women find that their period arrives sometime around week six or seven after surgery, and at some time in the four weeks after their hCG levels have fallen to 0 if treated with Methotrexate.
I am not sure on exact dates for yourself but if you haven't experienced a period before 10 weeks after your hCG had fallen to per pregnancy levels, seek medical advice.
You mention that you are not pregnant, If you are absolutely positive about this, I would continue with the above advice. If there is the slightest chance you could be pregnant and you have not had a period, please seek medical advice.

As a gentle reminder regarding trying to conceive post methotrexate injections, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood tests) and then 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.

Sending much love,
Karen x

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