Dear ca_ganesha,
I am so sorry to hear of your ectopic pregnancy and loss,
It is natural to be worried after everything you have been through. Sadly even with IVF there is the risk of ectopic pregnancy. However it is important to remember that help is available and your doctors should book you in for an early scan at around six weeks to check that the embryo is in the right place. I am not sure where you are located but if you are in the UK you can also contact your local Early Pregnancy Unit direct and self refer for an early scan. This can also give you peace of mind that you have the care available should you need some reassurance.
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).
Following methotrexate injection, beta hCG levels will continue to be monitored every 3-7 days 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.
The risk associated with treating being treated medically is that the medicine may not work as the cells of the ectopic pregnancy may continue to divide, which could result in there still being a need for surgery. Success rates do vary depending on the circumstances in which methotrexate is given and studies report success rates of 65-95%. Success rates tend to be higher with lower serum hCG levels. Your doctor should be able to tell you the success rate of methotrexate in their unit. Doctors can tell if the specialised cells of a pregnancy that produce the hCG hormone are still dividing because the hCG level will continue to rise and not fall. This will be monitored through blood tests. If levels are not reducing as expected, your Dr will discuss options with you, and this would possibly be surgery, but you and your doctor should decide on this together.
Occasionally, an ectopic pregnancy can rupture despite low hCG levels. Your hospital should have given you a number to contact for health advice if you feel that anything is changing, or you will have been told to report to the Accident and Emergency (A&E) department. If you have not been told what to do and need to speak to someone ring the hospital department which is treating you or the NHS 111 Service by dialling 111.
I understand this is very worrying time, I too had methotrexate injection and panicked at every twinge, however my treatment was successful. Try to take care of yourself, do not do any heavy lifting (including housework) or strenuous exercise. Hopefully you will soon start to see a drop in your hCG levels to out your mind at ease.
We will be here for you for as long as you need,
Sending much love,
Karen x
The Ectopic Pregnancy Trust
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