Bleeding since 4weeks, no pain, large mass, HCG falling

Hi there,

I tested positive for pregnancy on Oct 27th which would have made me 3 weeks pregnant at the time. The day after I had what felt like a rush of blood/warm feeling liquid and the same week I had very light brown bleeding. On Friday 1st November, I had what felt like trapped wind and mild discomfort and red blood bleeding slightly heavier than the previous week.

I rang EPAU and contacted my GP but due to being under 6 weeks, an ultrasound what not an option.

I experienced a period style bleed w/c 11th November which lasted around a week.

Since then I have had light bleeding.

At 6 weeks, I contacted the EPAU who did an ultrasound and a HCG test and confirmed I had a 4cm mass next to my womb (which is presumed ectopic) and HCG 380.

The options given to me were surgery or expected management. Due to the size of the mass, methotrexate wasn’t an option.

I have had no pain throughout it all (other than in week 3-4 when I had what felt like trapped wind) and my levels of HCG have fallen although suboptimally.

My last level of HCG was 57 but the mass still remained 4cm (no change within a week despite falling HCG).

I have decided to wait for my HCG levels to fall to 0 and to just hope the mass reduces.

Has anyone had any experience of a large mass but low falling HCG levels and gone down the waiting it out route?

Am I right in thinking of my levels are 0 my risk of rupture is gone?

Has anyone experienced anything similar?

This has honestly been such a crap time.

Dear Clester,
I am so sorry to hear of your ectopic pregnancy loss.
As a general rule there is no risk of rupture once hCG levels fall below 5 as the mass is no longer developing. We have little data on how long it usually takes for masses to reabsorb as women and people aren’t routinely scanned following treatment.
We advise to wait for 3 months prior to trying to conceive and this generally leaves time for masses to reabsorb. If you would like closer follow up or a repeat scan, i would advise discussing this with your medical team now.

Sending much love,
Karen x