Dear Bht,
I am so sorry to hear of your ectopic pregnancy and loss,
Some doctors (mistakenly) think that because they have administered a second dose of Methotrexate that that they must also double the recovery time for the body. However, even in a second dose of Methotrexate, the dosage is still much lower than for treatment of other conditions and is still metabolised by the body very quickly.
Our medical advice is that, if you have had two injections, you should rely on your blood test results as an indicator of what is happening in your body and wait until your hCG levels have fallen to below 5mIU/mL in blood tests and then can restart taking vitamin/folic acid supplements. Also, in the first week it is important to avoid pain killers which fall into the NSAID group such as ibuprofen.
Following Methotrexate however, 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.
I hope this helps answer your question,
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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