Hi everyone, I unfortunately have received the news that I have an ectopic pregnancy which has been located in my fallopian tube on a scan. My baseline HCG is 1900 which is above the threshold for expectant management. So I have been offered a choice between methotrexate and surgery. I have a strong instinct towards surgery, but it seems like a lot of women on this board do opt for methotrexate, at even higher HCG levels for me. I would be grateful to hear your experiences of the drug and whether you are happy with your decision or wish you’d opted for surgery? We are TTC so my main priority is future successful pregnancies as soon as possible.
Hey Rose
I had an ectopic in March and was also given the choice between methotrexate and surgery. I opted for the methotrexate and I have no regrets at all, although the thought of waiting 3 months to try again did put me off a little, it gave me time to heal and get myself in a better place before trying again. There was also the chance of rupture which also played on my mind, but overall I don’t regret my decision at all and after the 3 month wait we tried again as soon as we possibly could and I fell pregnant in the first month of trying again, and have now just started my third trimester!
Whatever you do I’m sure will be the right choice for you and I’m keeping everything crossed for you
xx
Hey,
Sorry you are going through this.
Last year I was told to make the choice between mxt or surgery, i was given no time to decide not because it was an emergency but I think where the doctor hadn’t spot it two weeks ago wanted to cover themselves.
I chose mxt because I didn’t want to be in hospital over xmas and the idea of my fallopian tube being taken I didn’t like.
Now I know what I know I would have had the surgery and here’s the list of reasons why:
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my hcg was 4600, it took 10 weeks to get to a hcg of 0 so had weekly visits to the hospital for that long
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for 10 weeks, every other day, my body painfully contracted and kept bleeding. The pain was barbaric lasted 4 hours at a time. Sometimes blood would pour out of me. It was awful. I’m still not over it.
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the docs do not give proper pain relief, they say paracetamol or mixed with codeine, if your pain is stronger you are told to go to A and E for an up to 6 hour wait. If I had the surgery they I would have got proper pain relief.
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I was doing ivf anyway so didn’t need my tubes to get pregnant again
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I feel like removing my tube may minimise the risk of another ectopic the baby won’t go in to that tube again
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the fear of rupture is so scary with the baby still present, could collapse at any time even tho the risk decreases as the hcg lowers
It is your decision, I’m just sharing my own experience which was traumatic because of the extreme pain I was left in, but your experience may be different.
Let us know what you decide.
rose2024:
Hi everyone, I unfortunately have received the news that I have an ectopic pregnancy which has been located in my fallopian tube on a scan. My baseline HCG is 1900 which is above the threshold for expectant management. So I have been offered a choice between methotrexate and surgery. I have a strong instinct towards surgery, but it seems like a lot of women on this board do opt for methotrexate, at even higher HCG levels for me. I would be grateful to hear your experiences of the drug and whether you are happy with your decision or wish you’d opted for surgery? We are TTC so my main priority is future successful pregnancies as soon as possible.
Dear Rose,
I am so sorry to hear of your ectopic pregnancy loss,
This is a really difficult question to answer as people will have positive and negative experiences with methotrexate.
The downside of methotrexate is having to have regular blood tests, waiting for your hCG to get back to pre pregnancy levels and then having to wait 12 weeks Whilst taking folic acid suppliments before trying to conceive.
On the upside, Methotrexate was developed to stop women and people having to go through surgery. It is not as invasive as surgery and even with surgery we recommend waiting for 2 periods before trying to conceive. If you were unlucky enough to experience 2 ectopic pregnancies and needed both fallopian tubes removing, that would have big consequences for future fertility too.
There is no statistical difference between them with successful future pregnancies.
I had methotrexate and successfully conceived following treatment so it worked well for me.
We have more information on treating ectopic pregnancy on our website which I have copied here-
https://ectopic.org.uk/treating-an-ectopic-pregnancy
I would discuss your options with your medical team and with your family so you make a decision that is right for you.
Sending much love,
Karen x
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Hi Rose,
So sorry you’re going through this.
I don’t necessarily regret the methotrexate but I think if I was to have a second ectopic I’d opt for surgery. The waiting for hcg to return to 0 is awful, the anxiety can be crippling wondering if you’ll rupture anyway.
I had 2 doses because the first didn’t work and was back in ED 2 days after each one with extreme pain. It’s difficult to distinguish pain from medication between pain from ectopic/ possible rupture. It’s very mentally tormenting.
My last bloods 5 days ago was 195 so I’m hoping I’ll be down to 0 at the end of the week or by next week.
Best of luck xxx
Hi everyone, thanks so much for your replies! My second HCG ended up being 2,700 and the embryo in the tube has started to develop a structure. They actually found a sac in my uterus as well and my progesterone was 79. Because of this they recommended surgery to potentially preserve uterine pregnancy. So I had the surgery on Friday 5th January. All went well and other tube looked good. I am relieved to not be going back and forth to hospital for HCG tests and not to worry about rupture, but also glad the decision was out of my hands in some respects! Recovery has been harder than I expected, I tried to return to work (WFH) yesterday and couldn’t sit up for more than 15 minutes so had to stop at lunch and ended up sleeping until 6pm - and then had no trouble sleeping 9 hours last night. It’s 10am and I would love to go back to sleep again! Work is being super understanding and I do have the sick note for 2 weeks off anyway so just plodding through some easy tasks.
Based on the level of bleeding and cramping I experienced Monday and Tuesday I am assuming that the uterine pregnancy has miscarried as well unfortunately. It was highly likely with all that went on during surgery and with the HCG drop that would have occurred when the tube pregnancy was removed. Part of me wonders whether more could have been done to protect the uterus pregnancy (like maybe a progesterone supplement to not shock it?) but that’s all done now anyway and it wasn’t the doctors main priority at the time.
But it’s crazy to think I could have had identical twins! Part of me wonders if it was the cells dividing into twins inside the tube that caused the ectopic? Like maybe they split and one twin got squished into the side and embedded accidentally. Very much a theory I have plucked out of thin air haha but it could be true!
Anyway, wishing you all the best of luck if you’re still on your TTC journey x
Hey,
Thanks for updating.
Surgery would have been the only option for sure as mxt would have affected both fetuses.
Sorry to hear your ectopic then lead on to a miscarriage. Your body has been through a lot and also your emotions. So it’s important to take it easy and also be kind to yourself.
Its natural to think about what if this or what if that. The truth is no one knows why some individuals have an ectopic, like there are women who have obstacles in their tubes so that’s clear but many other women we just never know why because in early pregnancy there are so many unknowns.
Myself my ectopic the EPU nurses subtly blamed it on IVF, then the IVF doc mentioned well I do have a fibroid in my womb so it could have been that, whilst I say many women who do ivf or have fibroids don’t have ectopic pregnancies, the chances are so low.
In your past post you said you would like to try again in the future. Know that many women go on to have healthy pregnancies after an ectopic. I’m taking a break from TTC but want to try again in the spring. So hope your journey goes well too.