HCG 0 after cornual

Hey

I have a cornual ectopic pregnancy, the sac is about 4 cm, i had 5 MTX shots, and the HCG is finally 0 (was 7000 at the beginning).

but the sac is still about 4 cm

At the hospital, they said that if the sac did not disappear/absorb in two months, they would have to operate on me to remove the abnormal finding.

I have 3 questions:

  1. How long did it take you to get your period after the HCG is 0 ?

  2. When should the sac absorb? disappear? Going out together with a the period?

  3. In a hospital they said we can have sex, but not get pregnant right now. Isn’t it dangerous to have sex if the sac still in place? There is no fear that it will tear?

I am afraid to do the surgery, since its consequences will be the same as if I had done the surgery before I received the injections.

I must say that I feel good, nothing hurts.

thanks

Dear gurigur,

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

Cornual ectopic pregnancies are rare and because of this, we don’t have as much knowledge base to advise.

I do wonder however if you were treated outside of the UK? In the UK, usual treatment for cornual ectopic pregnancies is surgery. I therefore cannot answer the question on how long it would take for the sac to be absorbed naturally as I don’t think we have data on this. I will check with the wider medical team and update this post with any further information though. Similarly on your question regarding sex, I do not have the answer to this as we are a UK based charity, so can only discuss methods used here in the UK and we don’t have this sort of evidence. You mention you have a follow up scan in 2 months, if you are concerned, you could find other ways to be intimate with your partner without penetrative intercourse.

When treated if treated with methotrexate, you can expect your period at some time in the four weeks after hCG levels have fallen to below 100 mIU/mL. According to a study for women who had methotrexate treatment for an ectopic pregnancy in a Fallopian tube, periods generally return to normal after an average of 24 days (range of 24–38 days) from the pregnancy ending.

The first period may be more painful or less so than usual, heavier or lighter, and last for longer or shorter than usual – there really is no set pattern. You should be able to manage the discomfort with over-the-counter (OTC) pain relief medications and should not be soaking a pad in less than an hour. If this is not the case, you should seek medical advice.

I am sorry I have not been able to fully answer your questions, but this is a rare type of ectopic pregnancy and the treatment you have been given is not common practice. I will try to find out more from our wider team, but I would suggest contacting your medical team to discuss your concerns and questions. They will have access to your medical notes and also may have more information on after care advice, if methotrexate is commonly used.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

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Hi Gurigur,

How are you getting on? I was diagnosed with a cornual ectopic pregnancy about 7-8 weeks ago following an early scan (I’ve had 3 previous losses). I’ve had 2x MTX injections and my highest hcg levels went to 15,500 so it’s taking a long time for my levels to come down! I’m currently around the 400 mark. Going in on Wednesday for repeat bloods and this time they are going to scan me to see if the sac is still there. If it is, an op will be on the cards which I want to avoid as you can imagine. I’ve also been bleeding now for coming up to 5 weeks.

I’ve never come across anyone who’s gone through the same so I am here if you need to talk about any of it.

My 2nd loss was a suspected ectopic where my fallopian tube was removed, but we later found out it was an intrauterine pregnancy and the swelling on my tube was due to endometriosis! 3rd loss was suspected ectopic where I was treated with MTX but later found out it was intrauterine again. It’s been an awful journey so far. Praying for a healthy pregnancy one day

Sending you strength and positivity x