Hi Sneha3012,
I am so sorry to hear you are suffering an ectopic pregnancy and loss, and going through this worrying time. I’m not medically qualified to comment on your specific situation and I will do my best to help.
As you’ve already experienced, the second shot of MTX will be given if hCG levels do not fall as doctors would like. In general, the hCG level often rises 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. If there has not been a 15% drop, this is when the doctors will consider a second dose of Methotrexate or surgery.
Every 3-7 days, beta hCG levels will continue to be monitored to ensure that they are falling appropriately. Most women only need one injection but in up to a quarter of cases a further injection may be required if serum hCG levels are not decreasing.
It’s very important that you continue to be monitored through blood tests, and I’d strongly encourage you to continue reaching out to your doctors with any concerns. Certainly, if there is an increase in bleeding or pain, especially shoulder tip pain, it will be important to seek medical attention through your A&E.
I know what an anxious time this can be, and want you to know that we are here for you throughout.
With good wishes,
Michele
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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