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Hcg rising day 4 after MTX shot

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Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Hcg rising day 4 after MTX shot

Post by Mistyappie »

Hi everyone,

My name is Susan, I am new here. Recently I was diagnosed with ectopic pregnancy at 5-6wk after IVF fresh transfer, was scanned and given methotrexate shot at 538 hcg. I went back for day 4 blood test today and my hcg has doubled to 1012. I am very worried now, I know it is normal for hcg level to go up on first blood test, however nearly 100% is quite scary. I was told to come back on Wed for day 7 blood test. I really don't want a second shot, but looks like it might be my next step. Anyone has experience with high hcg level on day 4 test and didn't need a second mtx shot? Thanks so much for reading.

EPT Host 20
Posts: 2276
Joined: Thu May 31, 2012 9:58 pm

Re: Hcg rising day 4 after MTX shot

Post by EPT Host 20 »

Dear Mistyappie,
I am so sorry to hear of your ectopic pregnancy and loss,
you are right in that the hCG level often rises on the day four blood test because the action of Methotrexate is not instantaneous, so the cells will have continued to divide for two or three days after the injection was given, and some cells release more hCG when they start to disappear. Your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven. If there has not been a 15% drop, this is when the doctors will consider a second dose of Methotrexate or surgery.
I can understand your feeling nervous about more treatment and this is very normal after your ordeal. Recovery from ectopic pregnancy is a challenging time and it is very important to ensure that you stay safe. Your doctors can guide you through your treatment and we are here to lean on for emotional support, too.

Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
**************************************************************************
During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.
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
Take a look at our newsletters 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
***************************************************************************

Kriluma
Posts: 10
Joined: Mon May 17, 2021 1:01 pm

Re: Hcg rising day 4 after MTX shot

Post by Kriluma »

Hi. I think is normal to rise on day 4 . Mine actually droped on day 4 by half. But today on day 7 they have risen by 3 units . I was offered the second injection or to wait until thursday. My numbers have been like this 334 hcg when shot was given . 143 on day 4 , 147hcg on day 7. Im a bit scared now as they should have fallen on day 7.

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Hi Karen and Kriluma,

Thank you for taking the time to reply to my post. I just got my day 7 blood done today, my hcg has gone up again to 1300 now. I'm not sure how it happened, I have cut out all folate rich food after the shot. I am waiting for doctor to see what to do with me now, more likely the second shot will be needed. I am very scared now, really hope this second shot will work so I don't have to go through surgery. More waiting and blood tests to go through ๐Ÿ˜”๐Ÿ˜”๐Ÿ˜”

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Update on this

After talking to doctor I decided on the second MTX shot, I did ask about the chance of it working, since the first injection my hcg didn't reduce at all. Was told that it's unlikely that it will work this time, however since I am not in much pain she's happy for me to have the second injection. I am prepared that it might not work, I just have to try. 1 more week if no decrease I will have to do surgery! Just want to get this over with.

EPT Host 20
Posts: 2276
Joined: Thu May 31, 2012 9:58 pm

Re: Hcg rising day 4 after MTX shot

Post by EPT Host 20 »

Dear Susan,
I am sorry your levels rose. I must emphasise that it is nothing you are doing wrong, for some ectopic pregnancies the methotrexate just does not work and there is no reasoning for this.
A second dose of methotrexate can be effective so try to remain positive and it is good to hear that you are not in pain. Although I do not wish to alarm you, I do have to remind you to seek urgent medical advice with any worsening symptoms of abdominal pain, heavy bleeding or you feel dizzy and unwell.
I hope this injection works for you,
Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
**************************************************************************
During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.
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
Take a look at our newsletters 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
***************************************************************************

Kriluma
Posts: 10
Joined: Mon May 17, 2021 1:01 pm

Re: Hcg rising day 4 after MTX shot

Post by Kriluma »

Hi. Any update ? How are you feeling now? Did the levels drop , have u had any pain or bleeding after the MTX, on my last levels they had dropped at 118 so they did not offer any other injection to me, next bloods on Monday I am hoping they dropped more. Its been such a nightmare. I dont have pains either. My mass is 1.9 cm , but I have been bleeding since 5 weeks even before MTX which is 20 days straight. I feel drained .

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Hi Karen and Kriluma and whoever is reading this,

I came back to have my follow up blood test today after my second MTX shot, my hcg reduced very little from 1300 to 1277. I was surprised it had gone down, i thought the opposite. Anyway the gyne on shift told me the drop is very little and they prefer to keep me overnight to observe and do another blood test in the morning. If hcg still doesn't want to drop much I think surgery tomorrow for me. Anyway, I just want this to be over. I feel good about staying in Emergency, if anything they will take care of me.

Dear Kriluma, good thing your level has dropped, pray for you to get to zero soon! This is such a horrible thing to go through, but we will get to the end of it, it will pass. Good thoughts to you!

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Oh and I also don't have much pain and pretty much no bleeding since the first mtx shot maybe that's why they want me to do surgery as it doesn't look like the second shot works

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Just an update
So last night they kept me in the ward for observation, around 4am I had some cramps (like period cramps) and small amount of bleeding. Have been bleeding small amount since. In the morning they took another blood sample and the result came back, my HCG dropped overnight from 1277 to 939!! Finally it dropped some. So because of this doctor said maybe don't need surgery yet, discharged me and I was told to come back for a follow up blood test in 2 days (so this Wed). She said if it keeps dropping then we can just do weekly blood test.

Funny thing when my hcg started to drop I wasn't eating strict folate free diet, one part because I was tired of not eating vegies and fruits, and it didn't seem to work anyway. Then it just dropped on its own. Maybe second shot of MTx just started working now :) hopefully another drop for me on Wed.

Kriluma
Posts: 10
Joined: Mon May 17, 2021 1:01 pm

Re: Hcg rising day 4 after MTX shot

Post by Kriluma »

Im glad there was a turn around on your levels and they dropped quite a bit . Hope they drop more by Wednesday and you are able to avoid the surgery. I had my levels checked today and they have dropped to 31 , and I feel a bot relieved. Maybe the bleeding has to do with levels dropping as I have been having bleeding daily. My next tests and nurse said probably my last are next Tuesday. I hope it will be over soon for us. Good luck and keep us posted .

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Hi everyone,

401!!! I just got the results for my blood test today, HCG dropped from 939 on Monday to 401 today!! I know I am not out of the woods yet, but it is heading in the right direction. Still having cramps and light bleeding, however I think maybe because the drug is working.

Hi Kriluma, so great that your level is now so low! Nearly the end for you, I was also told to come back for weekly blood test now. We can do this!

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Just an update on my situation in case anyone might find it useful. My mtx journey

13/5 583 first mtx shot
16/5 1012
19/5 1300 second mtx shot
23/5 1277
24/5 939 ๐Ÿ˜ฒ
26/5 401 ๐Ÿ˜
02/06 78 ๐Ÿ˜„๐Ÿ˜„๐Ÿ˜„
05/06 13
09/06 4 negative yayyyy

Discharged today. I still feel a little crampy, but not too bad. Hopefully no more spotting/bleeding for a while. Thanks everyone for reading my story!

EPT Host 20
Posts: 2276
Joined: Thu May 31, 2012 9:58 pm

Re: Hcg rising day 4 after MTX shot

Post by EPT Host 20 »

Dear Mistyappie,
Thank you for keeping us updated, we hear from many women who have to have a second injection and It is such a worry. Your experience will bring hope to so many.
It is normal to feel discomfort following treatment for ectopic pregnancy and this should settle in the next few months.

Above all be kind to yourself and allow time to grieve, to heal both physically and emotionally.
Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
**************************************************************************
During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.
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
Take a look at our newsletters 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
***************************************************************************

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 4:16 am

Re: Hcg rising day 4 after MTX shot

Post by Mistyappie »

Thanks so much Karen!

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