I had an ectopic (right tube) at the start of June with an HCG of 5000 and received a single dose of methotrexate which was successful. I had my first period on 1st July, ovulated on 15th July and now have my second period. I restarted folic acid (800mcg) at end of June when HCG was 6.
The advice for TTC is 3 months or 2 cycles. Technically this means I could start TTC mid-August (10 weeks after Methotrexate and 7 weeks of folic acid later).
Then they say you must have folic acid for at least 12 weeks prior to conceiving?! So given that the HCG takes a few weeks (or more) to fall to <5 after Methotrexate (the level at which it is safe to commence folic acid), then surely the advice of 3 months/2 cycles is irrelevant?
I’m sorry for your loss. I am glad you’ve asked this as that is exactly my question. I had my shot on 5th June and then started folic acid 3 weeks later. Due my second period next week. I don’t want to rush but also I think starting to try again would give me more hope. Sorry I couldn’t answer your question but hopefully someone will be able to clear up the confusion.
Thanks for replying. I am sorry you have been/are going through this horrible experience also. Your dates almost match mine! This was a first pregnancy for me, with no ectopic risk factors, and you’re right, I also feel that trying again will help in many ways. I am ready - I am physically (and probably emotionally) back to normal. I think the advice given out is so varied and to be honest, I don’t think there is a ‘right’ answer as no-one truly knows. Nature is amazing. My gut feeling is to try this month. I hope whatever you decide, that everything works out well. Keep in touch! x
Hi. Sorry to hear what you are going through. I also had MTX treatment after my ectopic in 2008. I was told to wait exactly three months from date of MTX injection. I did loads of my own research about MTX half-life and folic acid depletion. I started folic acid as soon as I was HCG less than 5 and was counting the days to TTC. I decided to start at the mid-cycle fertile window stage of the third month which meant for me it had only been two cycles that I had used contraception for. I didn’t get pregnant until 5 months later anyway. I think you will be fine trying when you do. My consultant said the three months was a general guide and when I also talked to him about half lives he agreed that 2 months was probably fine too. I know how you feel about the urgency of wanting to try again and not missing opportunities.
Thanks for sharing your experience. That has really reassured me. I love hearing success stories after this ordeal because there is a bright light at the tunnel.
There doesn’t seem to be any advice for the dose of folic acid after methotrexate for those TTC. How much did you take? x
Hi all! I had Methotrexate 28th Nov 14. Was told min of 3mth but that it stays in your system for 100 days. I was told to start Folic Acid from the 1st March 15 and avoid alcohol also as side effects can be severe. All 3 consultants said this and to be honest my usually clear skin had a rough patch and my hair was taking a bit of a hammering. It was suggested we wait until May before we tried again. So that’s what we have done. However. My story little bit more dramatic as a week after my shot I ruptured and had and emergency laparoscopy to remove my right tube. That’s why 3 consultants! Had I have known id have gone for op instead of drug. Wont be having methotrexate ever again that’s for sure. Good luck all.
I think SJFT is probably right starting now is probably no big deal as it’s unlikely to happen the first month anyhow ;). I wish you all the luck with the next time and generally I believe we know our bodies best. We had a miscarriage at 11 weeks in February and so I’m feeling a little more cautious but we have a little ‘pick me up’ break planned for the fertile time of next month (not on purpose!) and so we might just see what happens.
Re: the folic acid I’ve been told by the gp to just go with the normal dose so fingers crossed. Definitely keep in touch though as much as it might sound weird it’s kinda comforting having someone else who’s been going through all this at the same time. At least we can try and get the best information between us, especially considering the confused info coming from the medical side.
Shellmalpas - you had a rough time. Horrible to rupture and lose a tube after methotrexate. Double blow!
Aric - well planned (and well deserved no doubt!) break. Just enjoy the baby making and forget about making a baby if that makes sense! Yes, will definitely keep in touch. Hope to hear happy news soon! x
That sounds like good advice. The excitement of trying again is completely mixed with fear of what could happen next time. Good luck to you too and hopefully see you on the ttc post very soon
Yes I just use the regular folic acid dose too- I usually take the multivitamin tablets especially formulated for trying to conceive but also get folic acid from my cereals and leafy vegetables.
I met up with an old pal today for lunch and we talked about ectopics. The reason we became pals was that she had experienced a ruptured ectopic at about 10 weeks pregnant and lost her left tube. She then went on to have two daughters. It took her three months to get pregnant after ectopic and then about a year for her second daughter. No further miscarriages or ectopics.
I can’t decide whether to bother with Ovulation kits again. I suppose I have no clue where I am in my cycle anyway nor if my HCG is down to zero yet. I doubt it is because it has only been 12 days since operation. I’ll do test on Friday to see if levels undetectable. Then I might start LH surge testing.
OR I may just try to avoid having a clue where I am in my cycle and try focussing on other things…xx
I had my ectopic last Nov at 8-9 weeks had the mxt injections was told wait 6-9 months so I had the pill injections only had 2 lots so we ain’t covered but I have not seen a period since having the mxt injection. It broke my heart I have started taking the seven sea pre pregnancy tablet’s and my husband started multi vitamins same time. I have regular period pain n cramps but no show any advice please ???
It sounds horrible what you’ve been through. I’m not an expert but could your lack of period be due to the contraceptive pill? If not I’d see the doctor as I believe there is something they can do to induce a period.
Hello ladies, I had my shot for methotrexate on the 7th August and will be going for another blood test tomorrow morning to check my levels. My day 8 levels were 2552. Tomorrow is day 15. I started to bleed this week - which is my ectopic bleed not AF. It doesn’t seem to be too bad and funnily started around the time my cycle would have been anyway. We found out we were pregnant because of the positive test, despite having what seemed to be a late period in July. After a stressful two weeks of blood tests and scans they finally found my ectopic in my right tube next to my right ovary.
I actually feel that my body is already resetting and getting back to normal. All pregnancy symptoms have gone (including the horrible night sweats!). I’m expecting a big drop in my hCG levels tomorrow.
My question is I know I can’t start taking folic acid until 0, but assuming that happens in the next two weeks, is the 12 week guideline the minimum? Could a blood test to check my folate levels in November show whether I have topped up my levels enough? Doesn’t anyone know the folate measurement that is considered good to TTC? xx
I’m sorry for your loss but glad you are feeling OK at the moment. It’s a tough old time so be gentle with yourself. Regarding the 12 week minimum it seems pretty universal and tbh at first I felt like it was a lifetime but the physical break has been really helpful for me. In theory it should be possible to get a folate level check but when I went to the doctor for a liver function test 6 weeks after the mthx shot she didn’t seem keen on doing one and I was too exhausted to push. Folate level wise I have no idea :?
I totally agree and everything you’re feeling is completely justified. I have been counting down the weeks in totally obsessive manner. I found it especially difficult after I had my 2nd period but we’ve been good and now it’s just two weeks until we can try with a clear conscience. I keep thinking that at least if something goes wrong next time I won’t blame myself for not waiting. But of course I’m sure some women who have gone on to have a successful pregnancy after conceiving before 12 weeks.
Have you got a follow-up check up booked with your gp? I found doing that after 6 weeks gave me a bench mark and also a feeling like I was doing something. I’m a bit of a control freak and like you when I felt that my life was out of my control I needed to take a bit back.
Hi Aric, that’s a really good idea to have a 6 week check up xx My hCG levels dropped to 1128 on day 15 more than half the week before. Another blood test in 3 days. Hopefully will be around 700 and fingers crossed for a 0 by Friday. We are then going away for 5 days and would be lovely to start my folic acid again. I will at least feel the countdown has started then! I know I’ll be checking my ovulation LH surge each month so I know roughly when to expect it when we can try again. Then I’ll also feel my body is working again xx
Aric - how are you keeping? Really hoping that next month is your month and that all goes well for you.
I am in my two wait week now. Not feeling positive at all which I think is natural after going through an ectopic, and know I ovulated from my ectopic side as I experienced the discomfort I have always felt when ovulating from that side. I feel like I won’t be hugely disappointed as I am not expecting a positive, and next month I’ll be over the ‘3 month’ mark. There is of course always the fear in the back of your mind that it may be another ectopic.
Scuba - The 12 week folic acid guideline is exactly that - a guide. After taking folic acid for 5 weeks, I had my levels checked and they were actually above the normal range! The range is 4.6-18.7 and my levels read >20! I have been taking 2mg daily (5 x 400 microgram tablets). Again there is no firm advice on the dose of folic acid after a shot of methotrexate for ectopic, and many people would say to take the normal dose however I know that taking 2mg won’t do me harm.
Hi weebee, I’m good at the moment. The break really helped and actually we used contraception but the food and wine was worth it!
I have my fingers crossed for your tww. I know what you mean about ovulation pains, in fact during my last period I had pains too. I think I ovulated on the non-ectopic side last month as well – weird! Gonna ask a personal question now and obviously feel free not to answer but have you had any ectopic side niggles during sex? In certain positions (sorry tmi :oops: ) I have.
SJFT – haven’t heard from you in a while. How are you getting on? Hope things are progressing well.
Good luck to everyone whatever stage you’re at. It’s a tough journey but I’m grateful to have you ladies to talk to. xx
So glad to hear you had a lovely trip away-sounds delightful! We had a last minute ‘chill out’ holiday a few weeks ago and it was just what we needed.
Nothing is ever too much info! No I haven’t had any pain during sex. We haven’t been overly adventurous mind you, but even on deep penetration it hasn’t caused me discomfort. I know it’s not uncommon to feel similar twinges though (during sex/ovulation/period), especially as your body has a heightened sense of awareness following our traumatic experience!
I’m glad I have you all to chat to too. You’re great x
xx