Folic acid after methotrexate for Ectopic

Esb27 · 19 April 2021 10:46

Hi guys,

Am hoping to get the all clear this weds from the doc (3 weeks after my methotrexate injection) as my HGC was 15 last weds. Obviously I want to start taking folic acid again for 3 months to build up my levels so that we can start ttc again in July but I was wondering if anyone had taken stronger folic acid tablets prescribed by their doc (stronger than 400ug) or just went for the standard ones (400ug)?

I know methotrexate screws with your folic levels so keen to get them back up properly.

So scared of having another ectopic (this one was my 2nd) or miscarriage (I’ve also had two of these) but obviously am grateful to still have one tube left and want to keep trying until it hopefully happens naturally (or we have to have help with IVF).

Any advice on previous experiences taking folic acid after 1 methotrexate injection would be greatly appreciated!

EPT_Host_20 · 19 April 2021 18:27

Dear Esb27,

It is normal to feel anxious about the future. We experience a mix of emotions from wanting to try again to being petrified of what may lie ahead. We never forget but we can learn to accept what happened. It is a slow process that might be weeks or months ahead. In time, we can get to a place where we feel comfortable trying again. When this is, is individual for each person. There is no timeframe for recovery, take each day as it comes.

Importantly early scans avail. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.

You are right and it is advised to take a folic acid supplement for 12 weeks before you try to conceive following methotrexate. Methotrexate is metabolised quickly by the body, but it can affect the quality of your cells including those of your blood which is why it is recommended to take folic acid supplements. The dose in over the counter supplements is fine unless you have been advised to take a stronger dose by a medical professional.I

Sending much love,

Karen x

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Johnwick · 16 September 2021 15:46

Sorry to add to this thread.

So you take meth for 12 weeks so say December finish for us.

Then do we wait 12 weeks (having folic supplement in the meantime) so March 2022 to conceive?

Johnwick · 18 September 2021 21:14

Anyone?

EPT_Host_20 · 19 September 2021 18:50

Dear johnwick,

We advise waiting until hCG levels have fallen to below 5mIU/mL following the methotrexate injection and then take a folic acid supplement for 12 weeks before you try to conceive. So if your levels have just fallen to below 5, take folic acid for 12 weeks from now, so that will be December before trying to conceive.

This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the “wait” and then taking folic acid for 12 weeks before trying to conceive is so important.

I hope this answers your questions.

Sending much,