Methotrexate 2nd Injection Concern

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Hi there,

Unfortunately myself and my husband are currently experiencing an ectopic pregnancy. I’m a midwife so have seen it happen but never would expect it to happen to me given its 1 in 80. It was our first pregnancy and we are only 3 months married so we are beyond devastated. To what was meant to be an amazing exciting time we are just heartbroken.

After a lot of bloods, internal scans etc we eventually were told it’s an ectopic so I received the 1st methotrexate injection.

HCG levels were

Day 0 = 461

Day 4 = 198

Day 7 = 183

I found it hard going from praying levels to double to now praying they decrease. I thought it was a good thing but the hospital weren’t happy as they only seem to care about the numbers from day 4-7 so they wanted to bring me for surgery and I pretty much begged them not to.

The internal scan showed what was in my left tube had increased in size despite my HCG levels lowering so it added confusion as they said it’s rare for the 1st injection to not work given my levels were quite low to begin with. So they started doubting and suggesting maybe I never had an ectopic even though I had all the symptoms of bleeding, cramping on left side etc. They were then querying maybe I was having a non viable intrauterine pregnancy and somehow also had a cyst of some sort in my left tube. So made me even more uncertain and unclear.

They gave me 2 choices, 1. To go for surgery and may or may not remove my tube or 2. Try a 2nd methotrexate injection. I decided to go for the 2nd injection as I feel I’d always wonder what if, if I didn’t try.

My baseline HCG for the 2nd injection was 109 so my levels are coming down. I’ll be going in on Friday for my day 4 bloods and then Monday for my day 7 bloods.

I’m just wondering did anyone ever have any success with the 2nd injection?

And has anyone ever had decreasing hcg levels but then increasing size in their tube?

I just want this all to be over. I’m just so devastated and heartbroken, I can’t even begin to imagine future pregnancies. As a midwife I was quite anxious to begin with when I first out I was pregnant even before anything went wrong. And to now know that there’s a 10% chance this could happen again terrifies me. Everyone keeps saying to take it a day at a time and I’m really trying but every time I go to the bathroom and see blood on wiping and having cramps, they’re all just constant reminders. I wish this was all just an awful dream.

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Hi PennyH20,

My heart goes out to you reading this post. I am so sorry to hear you suffered an ectopic pregnancy and loss. It is difficult to bear, even when we understand what is happening. I had so much emotion around how unfair it felt and unexplained their reasons. Your emotions are natural, and we are here to support you however needed.

I’m not medically qualified to answer your specific questions. As a midwife, you likely have a better understanding than I do. I do know that my husband grieved differently than I did, and I found that journalling allowed us to keep the lines of communication open.

We at the Trust believe that talking through what happened and your emotions as and when you can help the healing process. We are more than happy to speak with you by email or telephone and answer any questions you may have or listen to your experience. Be kind to yourself in your recovery. We suffer both physical and emotional trauma through ectopic pregnancy, and it can take some time to feel back to ourselves. Please know we are here for you for as long as you need.

With good wishes,

Michele

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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