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Ectopic and methotrexate

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sjcoco84
Posts: 3
Joined: Mon Jun 28, 2021 6:29 pm

Ectopic and methotrexate

Post by sjcoco84 »

Hello ladies,

I am so thankful I have found you all, we are not alone.

I was just wondering if anyone can give any advice or success stories? Found a 9mm mass in my tube- no symptoms apart from spotting 2 days after my BFP. Was treated with methotrexate- hcg was in the 600’s. Fast forward 4 weeks my levels are now at 12 and have been discharged from the epu, and have been told to go back should I get another BFP in 3 months times. What has scared me is the no symptoms/ pains- I just thought I had an early miscarriage.

Will I be able to get pregnant? Will I have another one? Im so afraid and feel time isn’t in my side (I’ve just 37.) I hope there is someone out there with a lovely success story, or any other advice on how to look after myself? I just don’t understand as the doctors said my tubes looked fine, and aren’t willing to send me for any more tests unless it happens again. Which I also think is a joke- why would they want me to go through this again? I know it’s probably protocol, and I’m just being dramatic!

Also noticed I’m ovulating much early, with pain when I do which I never used to get!

Any advice or words will help me so much, Thank you.

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

Re: Ectopic and methotrexate

Post by EPT Host 20 »

Dear sjcoco,
I am so sorry to hear of your ectopic pregnancy and loss,
It is normal to feel anxious about the future. We experience a mix of emotions from wanting to try again to being petrified of what may lie ahead. We never forget our babies, but we can learn to accept what happened. It is a slow process that might be weeks or months ahead. In time, we can get to a place where we feel comfortable trying again. When this is, is individual for each person. There is no timeframe for recovery, take each day as it comes.
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.

In the UK, it is not standard practice to have any follow up tests following first ectopic pregnancy, unless directed by the doctor at the time.
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, help is available if conceiving naturally has not yet been successful after some time trying - and the EPT advises that women under 35 should seek medical advice following 12 months trying to conceive and those over 35 should seek advice after 6 months.

I know when I had my ectopic pregnancy, I was desperate to find a reason, but like you there wasn't one and this I know is difficult to understand. Sadly there is no way to prevent ectopic pregnancy in the future but the odds are in your favour to have a successful pregnancy next time. I had a successful pregnancy following methotrexate so I hope this helps give you hope.

Experiencing some pain after an ectopic pregnancy is normal as your body has been through a great deal recently. The pain may be your body preparing to ovulate and many women experience ovulation pain when they did not before their ectopic pregnancy - including myself. You also may have a heightened perception because of the sad loss that you have had to go through.
Your periods can take a while to get back to a rhythm that is more usual for you. I also found that my periods changed for a few months after my losses. If the pain persists, I suggest keeping a pain diary noting when the pain appears, the intensity on a scale of 0-10 and anything that helps the pain eg resting, hot water bottle, paracetamol etc. Visiting your doctors with this information helps them to assess how best to manage your symptoms.

As a gentle reminder following Methotrexate, 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.

Making the decision to begin trying to conceive is an emotional rollercoaster compounded by our sad loss. Again, you are not alone. We here emotional support whenever you need us. There is a specific Preparing for your Next Pregnancy board you can look at too whenever feel ready.

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
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sjcoco84
Posts: 3
Joined: Mon Jun 28, 2021 6:29 pm

Re: Ectopic and methotrexate

Post by sjcoco84 »

Thank you so much, you’ve given me so much hope for a healthy pregnancy next time. I’m not giving up xx

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