I had MTX on 6th Feb. HCG was back to normal by 27th Feb. The only feedback I had upon discharge was to not try to conceive for 3 months to allow my body to recover and the MTX to be out of the system. However I’ve been reading up we are almost at the end of the 3 months and see some women have been told the 3 months is to allow the folic acid levels to get back to normal. I only started taking folic acid again a couple of weeks ago. I went to the doctor this week to check and she said providing I have a normal healthy diet, no family history of neural tube defects and have started taking my folic acid now, she can’t see a problem with starting to try again but I wanted to see what the general consensus was here.
Thanks!
Dear Squidgy,
I am so sorry to hear of your ectopic pregnancy and loss.
We and other medical professionals advise you wait for three months or two full menstrual cycles (periods) before trying to conceive to allow your cycle to return and there to be a clear Last Menstrual Period (LMP) date to date a new pregnancy from – information that is invaluable in ensuring you are not suffering from another ectopic pregnancy in the future.
This wait also allows the internal inflammation and bruising from the ectopic and any associated treatment to heal and for the necessary process of grief to surface and be worked through. Some studies do suggest that women who conceive immediately after treatment for ectopic pregnancy are more at risk of suffering a subsequent ectopic.
With regards to methotraxate, if you have had either one or two injections, you should wait until your hCG levels have fallen to below 5mIU/mL 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.
I know this waiting time can be quite difficult and frustrating but I hope the information clarifies why we advise to wait.
Sending much love,
Karen x
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