Hi all, trying to make sense of conflicting advice re TTC after methotrexate.
One dose of MTX on 7th august.
I had a period like bleed after MTX on 22nd Aug. My hcg was 45 at this time.
I reached 7 hcg and was discharged on 29th august. Lots of negative tests taken in the last month all negative.
I have just had a period (20th September) so I seem to have fallen back into a regular cycle length quite quickly.
My next period dates should be
19th October and 16th November if I stay regular
Can I TTC in my October fertile window or do we need to wait until the end of November?
12 weeks from MTX will be 31st Oct.
I’ve been taking folic acid supplements again since discharge so I will have been taking this for 9 weeks by the end of October.
Confused if it should be 2 full cycles, 12 weeks from MTX or 12 weeks of folic acid before TTC again!
I was hoping we could TTC end of October but the want to be sure.
Any help much appreciated.
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Trying again after ectopic
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EPT Host 22
- Posts: 666
- Joined: Fri Nov 20, 2015 10:26 am
Re: Trying again after ectopic
Hi Headspace2020,
I'm so sorry to hear that you have suffered this ectopic pregnancy and loss. While I'm not medically qualified to comment on your specific situation, I will do my best to help.
The Trust recommends waiting three months to conceive. While there is no clear, researched evidence on how long a couple should wait to try to conceive after having treatment for ectopic pregnancy, we and other medical professionals advise that it may be best to wait for at least three months or two full menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is not your first period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy.
Physically, this timeframe is to allow your cycle to return to normal and for there to be a clear period to date a new pregnancy from. The date of the first day of the period is what is used to decide when to scan a new pregnancy; information that is invaluable in ensuring you are not suffering from another ectopic pregnancy.
The first proper period you have after an ectopic pregnancy may be heavier than usual and the second more like your usual period. A normal period would suggest you are hormonally ready to be able to try to conceive. Having two periods can also give an idea of menstrual cycle length, which may be different for a few months after your ectopic before settling back into its usual rhythm.
In addition to the physical aspects of ectopic pregnancy, many people also feel an intense emotional impact. Taking time before trying to conceive again enables the necessary process of grief to surface and be worked through. The emotional recovery that is often needed can be significant and many underestimate this aspect.
If you have had either one or two injections of methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood or urinary tests) and then take a folic acid supplement for 12 weeks before you try to conceive.
This is because the drug 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 cleft lip and palate, or even spina bifida or other neural tube defects.
I know this is a lot of information to process and we often want to get back to "normal" as quickly as possible. I encourage you to continue to be kind to yourself and take your ttc in your own time and as feels best for you.
With good wishes,
Michele
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
*************************************************************************
If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.
Further information is available on our website.
Email us: ept@ectopic.org.uk
We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.
Take a look at our newsletters and subscribe to our mailing list.
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'm so sorry to hear that you have suffered this ectopic pregnancy and loss. While I'm not medically qualified to comment on your specific situation, I will do my best to help.
The Trust recommends waiting three months to conceive. While there is no clear, researched evidence on how long a couple should wait to try to conceive after having treatment for ectopic pregnancy, we and other medical professionals advise that it may be best to wait for at least three months or two full menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is not your first period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy.
Physically, this timeframe is to allow your cycle to return to normal and for there to be a clear period to date a new pregnancy from. The date of the first day of the period is what is used to decide when to scan a new pregnancy; information that is invaluable in ensuring you are not suffering from another ectopic pregnancy.
The first proper period you have after an ectopic pregnancy may be heavier than usual and the second more like your usual period. A normal period would suggest you are hormonally ready to be able to try to conceive. Having two periods can also give an idea of menstrual cycle length, which may be different for a few months after your ectopic before settling back into its usual rhythm.
In addition to the physical aspects of ectopic pregnancy, many people also feel an intense emotional impact. Taking time before trying to conceive again enables the necessary process of grief to surface and be worked through. The emotional recovery that is often needed can be significant and many underestimate this aspect.
If you have had either one or two injections of methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood or urinary tests) and then take a folic acid supplement for 12 weeks before you try to conceive.
This is because the drug 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 cleft lip and palate, or even spina bifida or other neural tube defects.
I know this is a lot of information to process and we often want to get back to "normal" as quickly as possible. I encourage you to continue to be kind to yourself and take your ttc in your own time and as feels best for you.
With good wishes,
Michele
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
*************************************************************************
If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.
Further information is available on our website.
Email us: ept@ectopic.org.uk
We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.
Take a look at our newsletters and subscribe to our mailing list.
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
*************************************************************************
