7 weeks post methotrexate ectopic

Hi been reading through the board and found some really helpful information, I’m sorry that so many people have gone through this scary experience, a bit about my journey, I found out the 19th of April I was pregnant after trying for 3 years started bleeding heavily on the 25th April went to a&e it was assumed I was having a miscarriage as wasnt in pain just heavy bleeding and clots so was booked in with epu for scan and beta bloods, scan showed nothing so had bloods initial bloods were 1300 they dropped twice and went down to 1031 scan still showed nothing another lot of bloods then showed hcg had risen to 1400 another scan revealed nothing to see again so more bloods were done hcg had risen 2 more times up to 1872 because I wasn’t in any pain other then a niggly pain coming and going on left side and some bleeding I was just being monitored, it was decided on the 11th of May that I needed to go back in the next day for a final scan and a decision from the head consultant, she still couldn’t visualise anything on the scan but she suspected it was my left tube as she spotted a mass but due to heavy scar tissue on left side from a traumatic delivery of my youngest child the scan wasn’t easy so I had methotrexate on the 12th May never had many side effects I spotted continuously till May 30th hcg had been declining fast till the passed 2 weeks they dropped from 56 to 31 to 17 last week my hospital wont discharge till they are below 15 with no follow up, i had whst they think was a period the 18th June (only a week later then my normal period) when my hcg was 31, I have a few questions I can’t seem to get the answers to, as I wont know when I’m at zero when is it ok to start the contraceptive pill? And also is it safe for me to have sex now using condoms till I can start my pill? Sorry for the essay and help or advise would be greatly appreciated

Dear Amy88,

I am so sorry to hear of your ectopic pregnancy and loss,

Unfortunately I am not medically trained so cannot give you specific advice on your queries.

This advice is from our website-

If you are being treated with Medical Management (Methotrexate) or are being Expectantly Managed, you should avoid sexual activity which involves penetration until your hCG blood levels are down to less than 5 <mIU/mL. As hCG levels drop, the risk of rupture diminishes but, unfortunately, the risk remains even with very low hCG levels. For this reason we advise anything that increases intra-abdominal pressure, such as sexual intercourse, is best avoided.

Allowing the body to recover, ovulation to occur and the first period to arrive is often suggested by doctors as the ideal waiting period before women begin to have full penetrative intercourse (sex) again, which means waiting until around six weeks. This allows for healing of the muscles and gives you more confidence that your body is returning to its normal rhythm. Some couples, however, feel they want to have sex before this time and, ultimately, the decision about when to have sexual intercourse again is one for you and your partner and should be based on when you both feel ready. If you choose to wait, it does not mean that you cannot find other ways to be intimate should you choose to.

As you have been discharged from your EPU before your levels are below 5, I would suggest confirming with them or your GP.

With regards to your contraceptive pill, again I would advise chatting with your GP to ensure that it is safe for you to do so as your GP has access to your medical history and will be able to advise you properly. A lot of GP surgeries are running telephone consultations at this time so you should be able to speak to someone easily.

Sending much love,

Karen x

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