Dear Torialulu83,
I am so sorry to hear of your ectopic pregnancy and loss.
I too had methotraxate injections following my ectopic pregnancy and my bleeding started about 5 days after the injection but my abdominal pain worsened about a week after that.
I am afraid if is difficult to predict how long it will take for your bleeding to start and for your hormone levels reach non-pregnant levels. As we are all individual, our bodies respond differently to the drug and it depends on factors like how high levels reached and our unique physiology. What I can say is that it can take a number of weeks and, while it can take some time, it is not as invasive a procedure as surgery. It is also encouraging that your levels are falling although I appreciate that it can be a drawn out process. Also, in terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).
I completely understand you worrying about rupture, I did too. We advise that you do not undertake any strenuous exercise or lifting or housework while your hCG levels are dropping. You should also not resume exercise until your hCG levels are falling consistently and are in the low 100s. You should have open access to your EPU and if you become concerned about any symptoms, please do contact them.
As a gentle reminder, with one or two doses 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.
One of the side effects of methotraxate treatment is fatigue and many women feel very tired and are shocked by the exhaustion they experience through treatment. The impacts of the drug are on top of an already immense ordeal - the diagnostic process of ectopic pregnancy, regular visits to hospital, loss of a pregnancy which all take their toll physically and emotionally and is very understandable and normal.
Please take time to heal both physically and emotionally,
We will be here for you for as long as you need.
Sending much love,
Karen x
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