Methotrexate Experience

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Hi all, I found this forum very helpful while I was going through an ectopic back in December/January. I thought it might be helpful to share my experience to help others. Trigger warning ahead.

My ectopic experience started in December when I had what seemed like a real period and then never stopped spotting. I happened to take a pregnancy test the next week because I thought I might be miscarrying and it was positive. I only ever had a mild dull pain in my left side, no other symptoms other than the spotting. Long story short, the following week I ended up in the ER diagnosed with an ectopic in my left tube and was treated twice with MTX because my HCG quadrupled after the first dose. I bled every day for the next 12 weeks after my second dose of MTX which is what it took for my HCG to get down to zero. It was mostly spotting but sometimes heavier. At about 7 weeks after my second dose, I found what looked like a miscarried embryo in my toilet paper. I was not warned this might happen and honestly haven’t seen anyone on this thread even share that kind of experience. It was very traumatizing to say the least and the worst part was even after that it still took me 5 more weeks to get down to HCG zero.

I hope this story is helpful to someone out there just to know they are not alone.

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Dear Mglu76,

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

Some of this maybe difficult to read so please take your time and stop if it is too upsetting

Following methotrexate injection, The hCG levels fall. This triggers bleeding which is the body’s response to falling hormone levels because you are sadly no longer pregnant. The body expels the lining of the uterus that had built up in preparation for the pregnancy because it is no longer needed.

In many cases the the whole pregnancy sac including any cells that might have grown into a baby is usually reabsorbed by the body. However sometimes the tissue can separate and be passed through the vaginal bleeding that occurs. The bleeding that follows an ectopic pregnancy can be very heavy and clotty and result in the passing of what we call a decidual cast. This decidual cast is the lining of the uterus when we are pregnant. The sudden drop in hormones can cause the material inside the uterus to be shed in layers and the material that is passed can be grey, pink or white as well as appear like a clot or dark or frank red blood. Women can often mistake it for the tissue of their baby which can cause worry but it is important to remember that it is a normal process for the uterus lining to be shed.

Whilst I cannot be sure, this may have been what you experienced.

I am sorry you were not warned about this and naturally it caused such upset. Thank you for sharing your experience and helping others through this ordeal.

We too are here for you whenever you need us,

Sending much love,

Karen x

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Hello,

I’m so very sorry for your loss and to hear about what you went through. I read your post a while ago and I was looking for it this morning because I think I experienced something similar so I’m glad I found it. I have had bleeding for about 5 and half weeks so far. 2 and a half weeks ago I was given methotrexate. Yesterday the bleeding got a lot heavier, like a very heavy period. And this morning I passed what I thought was the pregnancy tissue and it really shocked me to see it. When I was given methotrexate, a nurse at the EPC told me that whilst most or all of the pregnancy will be reabsorbed by the body, sometimes some of the tissue can pass through the tube and then as vaginal bleeding. I wonder if this is what I experienced. Or maybe it was a decidual cast which Karen describes, although I hadn’t heard of this before. I really wasn’t expecting it to happen now, 2 and half weeks after getting the shot, but for you it sounds like a lot later. Thank you for sharing your experience, it was helpful for me. xx