Hi,
How does your HCG drop after methotrexate?
Mine started to drop 30% every two days in the first week but today it has only dropped 15% in the past two days. Does yours decline faster after week 1? Thanks!
Dear yingqing11
I am so sorry to hear of your ectopic pregnancy and loss,
The hCG level often rises on the day four blood test after methotrexate injection 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.
A few days after the injection, it is usual to begin to bleed and this bleeding can last between a few days and up to 6 weeks.
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. There is no set rule as to how quickly they reduce, and I am afraid it is difficult to predict how long it will take for your hormone levels reach non-pregnant levels. As we are all individual, our bodies respond differently to the drug and it depends on factors like how high levels reached and our unique physiology. What I can say is that it can take a number of weeks and, while it can take some time, it is not as invasive a procedure as surgery. It is also encouraging that your levels are falling steadily although I appreciate that it can be a drawn out process. Also, in terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).
Please be kind to yourself, we advise no heavy lifting or strenuous exercise whilst your levels are reducing.
Sending much love,
Karen x
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