Folic acid after methotrexate

I got a Confirmed ectopic and Methotrexate on the 17th June.

I found myself emotionally coping well as I had taken the attitude that ‘I’m alive and well again’.

Although Ive completed my 1st week back at work where I put on a brave face but lastnight and today I am a bag of emotions!

I’m seeing ALOT of friends on social media sharing their new born baby pics and scan pics and it’s so upsetting.

I feel really upset and angry at the world today. I thought I was dealing with it well but I don’t feel that I am this last 2 days.

Is this normal? I feel like I have emotionally went backwards.

And also I know we have to wait for 3months to try again, but Is that 3months from being given methotrexate or 3months from hcg levels down?

And when am I able to start taking folic acid as I have to take it 12 weeks before trying again.

Thank you x

Dear Jenni,

I am so sorry to hear of your ectopic pregnancy loss.

When we experience ectopic pregnancy, we are suddenly faced with a life threatening emergency and it’s treatments, reduction in fertility, concerns about the future and the loss of our babies. Experiencing any one of these is an ordeal, putting them together is immense and your feelings are completely normal.

We hear from many women who struggle with news about pregnancy from their friends and families. This is very normal and I was the same after my loss. When I had my ectopic pregnancy I had to attend a family function and a close family member was heavily pregnant. I spent the whole day and evening avoiding her as I found it too hard to be near her. It’s what I needed to do to get through the day and have some space and please protect your heart in whatever way you need. This does not make us “bad” people and it is possible to be happy for those around us while grieving for our own loss. Pregnancies and babies can be a very stark reminder of what could have been and it can be painful. Please do be gentle with yourself and you can talk to us whenever you need.

Following methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood or urinary tests) and then take a folic acid supplement for 12 weeks before you try to conceive.

This is because the drug 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 cleft lip and palate, or even spina bifida or other neural tube defects.

I hope this information helps. These boards are full of people who have experienced similar situations, they are a safe space to ask questions, gain support and even vent if needed and 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