I was recently treated with methotrexate for possible ectopic although they did see a gestation sac in my uterus but nothing else…but since my hcg was still increasing she told me it was necessary to get methotrexate. from what i am reading this is probably a blighted ovum. anyone else have the MD say anything similar? im just curious why they felt it was necessary to use such an aggressive medication for something we could of watched…my tubes were clear. I work in womens health (postpartum so this is all new info to me) at the hospital and am too nervous to question my Dr.
also, i received the methotrexate November 20th, miscarried the 30th. i started taking my prenatal again december 9th and started my first period Jan. 2nd. she told me to wait one cycle before trying again, although this feels too soon.
is the end of feb too early to try again?..i should have two cycles by then but im terrified to try again from the methotrexate. IS the danger the actual medication lingering still in my body or that my folate levels may be low? if this is the major concern why not just get a serum folate level to confirm the levels are high enough?
Hello, sorry to hear you’re going through this. I had similar treatment - ended up needing two methotrexate doses in October as my levels didn’t fall enough with one.
I’m in the UK and the NHS advise you to wait until your hcg has fully dropped and you get a negative pregnancy test and then a cycle before taking prenatals again (they can interfere with the MTX working). The Ectopic Trust recommend taking prenatals for twelve weeks before trying (which is about folate levels I believe) - my Early Pregnancy unit advised me to follow this guidance. So at this rate I won’t be able to try before March! Which seems a long time.
The methotrexate is in your liver and affecting ‘the quality of your blood and eggs’ for around 3-4 months, so I think it does make sense to have time for your body to fully recover.
I am so sorry to hear of your ectopic pregnancy and loss,
Unfortunately I am not medically trained so cannot give you specific advice on your questions however when hCG levels rise rather than fall, treatment is often required.
Regarding trying to conceive following 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. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the “wait” and then taking folic acid for 12 weeks before trying to conceive is so important.
Sending much love,
Karen x
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