Few days after methotrexate

Hello,

My ectopic pregnancy was confirmed on June 14th with HCG level of 3016 and the mass seen on the left side which has been growing over last 2 ultrasound. My provider gave me a dose of methotrexate on 14th evening.

Before the medication, I had mild bleeding and cramps which would come and go.

After the medication, bleeding has reduced by a lot. I do still have cramps. My 4th day HCG measured on 17th went upto 4524. It’s increasing at the same rate as before the medicine.

I am worried that the medication is not working for me. The clinic says to wait for day 7 HCG level.

I am anxious and just want this to be resolved ASAP. I feel like my life has stopped and I don’t know what’s going to happen next.

Has anyone else had similar reaction to the medicine?

Dear anxious_me,

I am so sorry to hear of your ectopic pregnancy loss and the worrying time you are going through.

Following methotrexate, it is really common for the hCG level to rise on the day four blood test because the action of methotrexate is not instantaneous, so the cells will have continued to divide for two or three days after the injection was given, and some cells release more hCG when they start to disappear. Your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven. This happened to me too and the hCG started to decline after the day 7 bloods. If there has not been a 15% drop, this is when the doctors will consider a second dose of methotrexate or surgery.

We have more information on methotrexate treatment on our website here, including how to.help the treatment work and avoiding strenuous exercise and heavy lifting

https://ectopic.org.uk/treating-an-ectopic-pregnancy

Diagnosis of baby loss, going through treatment and the loss of our babies can be very overwhelming and your feelings are completely normal. Be kind to yourself and allow time to grieve and heal physically and emotionally.

We will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information


If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team


Thank you for your response :slightly_smiling_face:

My 7th day hcg level was only 12.6% lower than 4th day. So I was called to get 2nd dose of MTX. Now I am told to wait for 7 days for next blood work.

After 2nd dose I had headache, felt nauseous.

I was tired in a similar way as after 1st dose. This makes me take nap in the middle of the day.

Though with 2nd dose I am also feeling some pain on my left side where ectopic pregnancy was detected. I have also noticed that my bleeding stops for couple of dose after each dose. Maybe one of the side effects of MTX.

I really wish my numbers to go down quickly.

On 7th day I was at 3950.

I will update here in few days after my next lab work for people who are interested in knowing the impact of 2nd dose. I really hope that I don’t have to take any more doses or go through surgery. I am completely drained physically, mentally, emotionally.

Dear anxious-me,

My bleeding started about a week after the injection and I too was absolutely exhausted.

After everything you have been through, it is normal to feel how you do.

He kind to yourself and allow time to grieve and heal both physically and emotionally.

We will be here for your updates, and inbetween if needed at all.

I am sending positive thoughts that your levels start going down.

Much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information


If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team


Hi all,

Thanks for reading my post here and supporting me.

I mentioned before that I had to take 2nd dose of MTX on 7th day. On the 14th day from 1st dose, I went for my blood work: HCG levels dropped by almost 50% compared to day 1.

I was happy. But that same evening, I had bad pain on the left side (where my ectopic is located). The pain was there for few hours. I couldn’t also sleep on my back with pelvic area touching the bed.

Next morning I went to see OB again. I started having bad abdominal cramps while waiting in the office. Looking at my pain and discomfort she asked for immediate US and blood work.

It wasn’t clear if the tube had ruptured but due to my pain level OB suggested for laparoscopy surgery. That time during the surgery she found that my left Fallopian tube had ruptured a day before and had intermediate bleeding in the abdomen area.

Now I am resting at home, hoping for the wounds to heal. But I am not sure if my right tube is ok or not. OB said right tube looked fine but was dilated.

Would I ever be able to conceive with this right dilated tube ?

Dear Anxious-me,

I am so sorry to hear you ended up needing surgery after everything you have been through.

As a general rule, you should take it very easily for about six weeks after surgery. Your body will be using its energies to heal internally. It is normal to feel physically and emotionally exhausted during this time and please do be kind to yourself. Recovery can take time and some days will be better than others, one day you maybe ok and the next you maybe in discomfort or more emotional. This is perfectly usual and the healing process will go back and forth in this way for however long you need. It is important to listen to your body’s signals and pain and feeling tired are your body’s signs to tell you to rest. We suggest keeping a healthy balanced diet, drinking lots of water and resting. Once your wounds have healed, very gentle exercise such as a short walk can help, but please do take this slowly.

I

You asked about trying to conceive with a dilated tube, unfortunately we cannot provide personalised medical advice and I would advise asking your doctors this question as they would be able to tell you more about the dilation and if this may impact your future fertility.

As a general rule when a person has only one fallopian tube and both ovaries, they are still able to get pregnant from an egg at the opposite ovary as an egg from one ovary can travel down the tube on the other side. The fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae begin to move gently creating a slight vacuum to suck the egg toward the end of the tube it is nearest to (like lots of little fingers waving and drawing the egg towards it). So, if you have only one tube then there is only one set of receptors working and one set of fimbriae creating a vacuum and so the egg is much more likely to find its way to that tube, whichever ovary it is produced from. Conservative estimates suggest that an egg produced on the tubeless side manages to descend the remaining tube around 15 to 20% of the time.

While generally it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information


If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team