Methotrexate and hormone level dropping

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1

Hi there!

Im very new here!

I was 6 weeks pregnant had a pregnancy of unknown location and started to miscarry as they thought,

I passed what i thought was the “sac” but pain intensified and bleeding got worse and a scan showed a tubal pregnancy on the right side

As my hormone levels were already at 81 they decided to use methotrexate to treat .

My question is in the 7 day period the came down to 61

(On day 4 bloods was 66) so they didnt incline as they expected which is a good thing

But my liver function is showing raised so i need more bloods done

I just feel like this is drawn out and even though its come down way past the 15% they wanted too but im worried ill need another shot of MTX, and also my liver function is worrying me too!

Anyone else had this experience? I was so wrong assuming cos my hormone levels are low this would be alot quicker process than if my hormone levels are in their 1000s :frowning:

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Hi Steffi

I thought I would say I’m in a similar situation to you. My HCG level was at 200 (so not that high) and I was given Methotrexate. A week later it was 140. A week after that it went to 110. I received my latest blood test results today and my HCG level is now 100. The nurse who gave my results is having to go to the consultant tomorrow morning. I like you am thinking this is taking a long time to come down (anyone else having this experience/knows how long this is likely to go in for?). I think the important point is that it is coming down but I’ll let you know if I hear anything to the contrary tomorrow.

I hope you are feeling ok. The Methotrexate has really made me exhausted on top of the emotional stress…

Best wishes

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Hi Phoebe

Thanks so much for getting back to me.

It’s reassuring im not alone in this, im desperate to get back to normal and be a family and get back to work etc. And going back to the same place i had the bad news i lost my baby is daunting.

Please keep me posted :slight_smile:

Ive been ok as sorts on MTX slight cramping and tirdness but had bad mouth ulcers (mind u i did catch a cold from my daughter at the same time!)

I just dont want another dose if i can help it!

I hope we both can get past this soon!

Xxx

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Dear Steffi_89,

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

Generally, the hCG level often rises on the day four blood test 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. I presume that you have had further blood tests and if there hasn’t been a further 15% drop, this is when the doctors will consider a second dose of Methotrexate or surgery.

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 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. From what I understand, the chance of a successful pregnancy is determined much more by the health of the opposite tube.

Above all be kind to yourself, do not undertake any heavy lifting, housework or exercise whilst your levels are dropping.

Sending much love,

Karen x

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Hi Karen thanks for your response it is really helpful.

Steffi you are definitely not alone on this. In terms of an update I have to go back for another blood test in a week and then it will depend upon that result as to what happens next. I like you really do not want another dose of Methotrexate if I can avoid it. Not only due to the tiredness and on and off cramping pains but because my husband and I want to start a family and it is bad enough I will have to wait 3 months post methotrexate. I don’t want to have to wait 6 months which I understand I will have to if I have a second dose.

I keep wishing for the HCG to go down and I hope that yours will go down too.

Wishing you all the best

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Hi phoebe!

Just asking to see how you got on? How are u? Xxx

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I had something similar. My HCG never got out of the 200s so I thought everything would be over really fast. Unfortunately I did have to have another dose of methotrexate as my HCG went up after going down. This made me extremely tired almost instantly and I struggled to get myself out of bed. Other than that I had no other side effects.

My doctor told me that because the HCG was so low, the drug basically has a smaller target to hit which is why it can take so long.

Good luck

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Hi Steffi

My levels have significantly dropped today. I now have an HCG level of 15. I have to go back in a week as they will not discharge me yet but it is looking more promising than it did a week ago. How are yours doing?

Thanks Tigletty for your response and I’m sorry you had to have another dose of that stuff. It’s quite interesting what the doctor said about it taking longer due to the lower levels so thank you for sharing.

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Hi

I thought I would update this thread just in case anyone reads this later and will find comfort in this.

I went for a blood test this morning and my HCG level is below 5. Yippee! This means I am now discharged. I’m hoping that my tiredness levels will now be reduced by the fact that I am not stressing about how this will work out.

Wishing you all the best