Injection or Surgery?

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1

Hi,

I had a positive pregnancy test on 19/07 but started to have brown discharge last Thursday (01/08) LMP was 18/06 so put me at 6 weeks+2 days when this all began.

I went to EPU on Friday (02/08) as the brown discharge was now brown blood. They only examined me and couldn’t scan until Tuesday. Whilst there, I started to have red, fresh blood that resembled what you would expect with a period.

Booked a private scan for Saturday (03/08) where they confirmed a complete miscarriage- which I found a little odd that it was complete due to the fact i had only been bleeding for a day and didn’t consider it heavy at all.

Went back for my NHS scan yesterday and they then dropped the bombshell it was a suspected Ectopic Pregnancy. Had a positive pregnancy test and they found a mass by my right ovary along with fluid in the pouch of Douglas. Blood test later showed HCG levels of 1674 (i’d be 7 weeks now). They said this isn’t low but also isn’t “high high”.

I was hoping for Expectant Management and was a due the 2nd blood test tomorrow but they have called and given me an appt with a consultant for 2:30pm today. I have been asked to think about my preference to the injection or surgery. I really don’t want either but obviously will do whichever is best for my health as have a 2 year old little boy.

My questions are:

Which is better for my future chances of having another baby?

I am worried about the side effects of the drug in my body and hate the idea of putting that into my system- but at the same time I don’t want to loose my tube if that lowers my chances of falling pregnant again?

But is it riskier to keep this tube if it is damaged and an ectopic pregnancy occurring again?

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Hi, so sorry you are going through all this worry. My daughter had a very similar experience to yours. She had the injection as she didn’t want to be laid up after surgery. I wouldn’t say she had a bad experience with the injection. Apparently you can’t try for another baby for 3 months after having the injection. After a week, she had another scan and unfortunately the injection hadn’t worked and the pregnancy was confirmed as being ectopic in the right tube. They hadn’t seen it on previous scans. She had surgery that day. They have taken right tube & ovary. Her left tube is in good condition. They say there is a 10% chance of having another ectopic, but I have read about so many success stories with having 1 tube. I hope everything works out for you. Take care x

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Hi, I opted for the injection. Luckily mine is working so far. The side effects are kicking my butt, nausea, fatigue, and now my levels are coming down bleeding and period pain (my periods while not on birth control have always been horrendous). However it’s definitely management if unpleasant. I can’t give any advice about the surgery.

The injection option is a long road of uncertainty. They’re predicting I’ll be discharged (from being an outpatient) in around a months time and I had it on 21st July with levels of about 1300, but that’s just a guess, they dont really know.

I dont regret my decision, and ultimately you have to do what your gut tells you. But all I can say is if I had to go back and make the decision again, needed a second injection, or had another ectopic, I would opt for surgery.

Do you plenty of reading around both options and go with your instinct. Hope that helps at least a little bit. Best wishes x

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Dear Graceberry,

I am so sorry to hear of your ectopic pregnancy and loss,

Sadly I am not medically trained so cannot give you specific advice on your questions however what I would say is that methotrexate has been developed as a less invasive method of treatment than surgery. Also, studies suggest that the chances of successful pregnancy are not significantly different between treatment methods ie whether having a tube removed of methotrexate.

Both require a recovery period before trying to conceive again. With methotrexate you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood tests) and then take a folic acid supplement for 12 weeks before you try to conceive.

Following surgery we and many medical professionals advise waiting at least two menstrual cycles before trying to conceive again - and this is the same with expectant management treatment, too (ie allowing time for the body to resolve the pregnancy without medical or surgical treatment).

Please note that the first bleed after an ectopic pregnancy, is not classed as a period - it is the body’s response to falling hormone levels as you are sadly no longer pregnant and shedding of the uterine lining that had build up which involves bleeding.

The chances of a further ectopic after a first in UK is 10%. So that’s 90% chance of the embryo being in right place next time.

While generally it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years.

I would advise taking advice from your medical team who have information on your individual circumstances, but I send you much love and warm hugs,

Karen x

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5

Hi All,

Thank you for you replies.

I have my 2nd blood results back and unfortunately my hCG levels have gone up from 1674 to 2221 in 48 hours so I either need the injection or surgery.

Is there anyone on here who has had opted in to the GEM3 trial? I have been offered this and trying to decide what to do. Have all the research and facts but keen to talk to anyone who has had it.

Thanks,

Grace