After methotrexate

Ivamn87 · 2 July 2020 08:59

Hi,

I was diagnosed with a persistent PUL, which after number of tests showed it was non-viable. The location could not be confirmed even with a HCG of 2800 at week 8 and I was given the option of waiting or taking methotrexate. Given a progesterone level of 14.7 nmol/L (which is too little for it to be viable) and HCG levels growing at around 50% i opted for taking a methotrexate injection. I had some bleeding at week 5-6 and was told I was miscarrying with a HCG of 63 and progesterone of 4.7. Its been 2w+4d since my injection. My HCG levels went up to 3230 on day 4 then 2106 on day 7 and then 251 on day 14. Between day 7 and day 14 I started bleeding quite heavily and also passed some clots. The bleeding has settled to low levels since last two day. I have read that in ectopic pregnancy one doesn’t pass clots. Is that true? I feel like I may have acted hastily.

Another question I had was is it okay to take just vitamin D supplements? I am dark skinned so take them throughout the year but had stopped taking them since the methotrexate injection as was told by the consultant to not take vitamin supplements. I am feeling very tired, more so now than even the first week I took the injection and doubt that it could be due to lowering of vitamin D. Also I have started going to work since last week and don’t want a seriously reduced immunity in the midst of this pandemic.

LittleP27 · 2 July 2020 20:59

Hi Ivamn87,

I am sorry to hear about your ectopic pregnancy. I also had injection 3 months ago and I was passing clots which I believe was the lining of the womb. My doctor said that due to my lining not being thick he wouldn’t recommend D&C and said that I will just pass it, which makes me think that was the reason of the clots?

I think they say not to take any supplements until your levels are below 5. I think it’s completely normal how you feel. I felt horrible after having mine, didn’t want to leave the bed just felt awful, I would definitely speak with your doctor on your next app maybe he can recommend something. I hope you feel better soon x

EPT_Host_20 · 4 July 2020 07:06

Dear Ivanm87,

I am so sorry to hear of your loss,

Methotrexate works by stopping the pregnancy developing any further and it is gradually reabsorbed by the body. We all experience very different bleeding patterns after it. Some ladies will spot lightly others will bleed more heavily with clots. This first bleed after treatment is a response to falling hormone levels and involves shedding of the uterine lining and is not classed as a period. The length of the bleeding can vary from woman to woman and some women do report spotting and bleeding for up to around six weeks after an ectopic pregnancy.

While this is usually nothing to worry about, if you find that the bleeding increases so that you are soaking more than a pad in an hour or have offensive smelling discharge or body temperature of more than 37°C, please do get medical attention.

Tiredness is also a side effect of methotrexate injection and many women are shocked at how fatigued they feel. We advise that you should stop taking any vitamins, minerals or other medicines unless you have been told by the doctors treating you to continue with them, as some medicines interfere with the effects of methotrexate. It is particularly important that you do not take any folic acid supplements until your doctors are sure that the drug has worked.

Regarding returning to work, it is worth considering that you have been through an awful lot lately and you may need a little longer off work, especially if you do not feel it is safe to return to work if you cannot take your supplements. In addition, it is worth bearing in mind that experiencing ectopic pregnancy is a very frightening experience and many women need to take time to help them deal with the psychological/emotional impact of the loss of their baby and being diagnosed with a life-threatening condition. Please speak to your GP about having further time off work if required.

We have more information on methotrexate injection on our website here-

https://ectopic.org.uk/patients/treatment/

Above all be kind to yourself and allow time to grieve, to heal both physically and emotionally.

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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Rachel21915 · 24 July 2020 06:10

Morning everyone!

I had Methotrexate back in May 2020.

Started having protected sex beginning June cause didn’t feel right before cause so much upset.

However unfortunately 4th July 2020 was our 5th anniversary and things led to another we was careful but the condom split

I didn’t know what to do anyway I went about my weeks think no I wouldn’t get pregnant yet it’s too early.

Needless to say I’ve taken 7tests in the past 5days and they’ve all come back Positive however the positive line isn’t very show so don’t think I’m.bery far gone.

I keep having this sick feeling it’s not showing much because I’m not pregnant I have in my head I’m not pregnant, btw I do really want to be pregnant would be amazing.

I called EPU to tell them which I’m booked in for a scan towards end August.

But now my worry is going and there being something wrong or they can’t see anything

Can anyone just give me a bit of reassurance that all will be ok and these tests are right lol.

Xxxxxxx

EPT_Host_20 · 27 July 2020 13:12

Dear Rachel21915,

Whispered congratulations on your pregnancy.

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

We generally advise to take folic acid for 12weeks after your hCG levels have fallen below 5. I am unsure from your post if you were able to wait this time. If you have fallen pregnant before being able to take folic acid supplements for 12 weeks, I would advise speaking to your GP and depending on your medical history, they may look at taking additional blood tests to check your folic acid levels.

Sending much love and positive thoughts,