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Methotrexate ectopic

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kayleigh1994
Posts: 21
Joined: Mon Aug 09, 2021 3:52 pm

Methotrexate ectopic

Post by kayleigh1994 »

This is my first post here. I got told I was having a ectopic pregnancy yesterday morning at my second scan, I’ve been going back and forth with pain and bleeding for 3 weeks after being sent up the day I had my positive by my doctors as a possible ectopic. Anyway the lady who did my scan told me it needed to be emergency surgery, my consultant then said I could have a choice, I went with the methotrexate and I’m just praying it works! I have no many thoughts going through my mind on conceiving again. I’m just so nervous

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

Re: Methotrexate ectopic

Post by EPT Host 20 »

Dear Kayleigh,
I am so sorry to hear of your ectopic pregnancy and loss, especially after the confusing time you have had. I will keep everything crossed that the methotrexate works well for you. I hope they have told you 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. So don't sorry if this happens, it is normal.

Regarding trying to conceive again, 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.

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.

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.

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.

Please continue to lean on us for as long as you need,
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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kayleigh1994
Posts: 21
Joined: Mon Aug 09, 2021 3:52 pm

Re: Methotrexate ectopic

Post by kayleigh1994 »

Thank you so much, I have been told 12 weeks everywhere but my doctor Monday told me 6 months after I finish treatment 😭 I have no clue why I did say in the booklet I was given it says 12 weeks and she said no it’s 6 months. I’m not in a huge rush anyway I just want this to be sorted first as I already have a little one to think about. My hcg levels were very low at there highest which is 167 which is from Monday so I am praying it works nice and quickly for me

kayleigh1994
Posts: 21
Joined: Mon Aug 09, 2021 3:52 pm

Re: Methotrexate ectopic

Post by kayleigh1994 »

Also while I’m on here. I’ve felt so ill since having it, like you know when you just feel ill there’s no real explanation. Is this normal and how long does it last

Bookworm
Posts: 28
Joined: Wed Jul 28, 2021 6:26 pm

Re: Methotrexate ectopic

Post by Bookworm »

Hi Kayleigh,

Really sorry to hear about your ectopic just wanted to share my experience briefly in the hope it might help you. My HCG was 1600 when they decided to treat it with methotrexate. It went up after the first injection to 3888 but I had a second injection last Tuesday and as of Monday it has come to 2798 and I go for more bloods tomorrow.

I just wanted to tell you that I’ve felt really unwell since having it too. I felt nauseous and have had an upset tummy but the main thing really has been the tiredness and general feeling of just being ‘unwell’ and ‘off’ so I think it is normal to feel that way. It’s quite a strong drug so take care of yourself and rest when your body tells you it needs it.

In terms of trying again my doctor also told me 6 months so I questioned this as the booklet said 3. She said it’s because the methotrexate depletes the folic acid in the body so 3 months for the drug to leave; then take folic acid for 3 months to get levels back up before trying just to make sure there’s no risks from the lack of folic acid. Hope that helps and hoping for a swift recovery for you.

kayleigh1994
Posts: 21
Joined: Mon Aug 09, 2021 3:52 pm

Re: Methotrexate ectopic

Post by kayleigh1994 »

Thank you. You too ❤️

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