Methotrexate experience's

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1

Got told I was having an ectopic pregnancy on 30th June , been 7 days since I got my first methotrexate injection.

Side effects have been mild cramping one sided and lower back pain as well as a few headaches starting on day 3 and dark brown spotting (discharge). No bleeding at all.

Had my day 4 HCG test and my levels had just over doubled again.

Found this out today on my day 7 blood test as hospital never rang me to tell me and I’m going a bit crazy with anxiety thinking that it’s not worked. (Said they would ring me by tomorrow evening with test results from today)

Is it normal for it to go up on day 4? It’s been a very stressful few weeks and it just feels like a forever waiting game.

Anyone who has been through this I would really really appreciate your experiences as it’s my first pregnancy and I’m a bit overwhelmed with all the info I’ve been getting.

HCG levels:

24th June- 128

26th June- 219

28th June- 491

30th June -991

4th June- 2170

Thank you! X

2

Dear Nicole,

I am so sorry to hear of your ectopic pregnancy loss and the worrying time you are going through.

I am sorry you weren’t pre-warned before hand, but 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. If there has not been a 15% drop, this is when the doctors will consider a second dose of methotrexate or surgery.

I know it can seem like a long drawn out process, but methotrexate is used as it isn’t as invasive as surgery. You may also be reassured to know that there is no statistical difference in the rates of successfully conceiving again between the three different treatment options (conservative management, methotrexate injection or surgery)

We have more information on treatment with methotrexate on our website here which maybe useful if you have not been given much information.

https://ectopic.org.uk/treating-an-ecto … thotrexate

We advise not to do any heavy lifting or strenuous exercise at this to and whilst I do not wish to alarm you, I do need to remind you to seek urgent medical advice with any heavy bleeding, worsening pain, shoulder too pain or you feel dizzy and unwell.

Sending much love and positive thoughts for a reduction in your bloods tomorrow,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

3

My partner has the same problem as you and she is also very worried because the levels have increased on the 4th day (which is today).

So can she somewhat rest assured and continue to watch?

4

Dear hector,

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

It is common for the day 4 bloods to rise after methotrexate. The doctors will be looking for a 15% reduction of hCG levels between day 4 and 7 bloods.

As long as your partner does not have any worsening bleeding or pain, or she starts feeling dizzy and unwell, it will be ok for her to wait and see what the day 7 results are. If she does develop any of these symptoms she must seem urgent medical advice.

If they are not reducing of continuing to rise, her doctors will speak to you both about next steps. These may include another injection of surgery, but it will depend upon her hCG levels on day 7 and how well she is.

This is all normal with methotrexate treatment.

Sending much love,

Karen

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

5

Thank you for your reply!!

Unfortunately had bad blood loss yesterday morning and really bad pains and after another scan was recommended to remove the tube as the ectopic was growing still- which I had done!

My HCG has now fallen to where they don’t need to see me again.

I’m aware no medical advice can be given on here but since I’ve had both a methotrexate shot just over a week ago and now the keyhole surgery would anyone suggest starting folic acid straight away or waiting a couple of weeks? I forgot to ask before I got discharged as I was a little bit foggy from the anaesthetic :frowning:

Thank you!

X

6

Dear Nicole,

I am so sorry to hear you had surgery. Please be kind to yourself and allow time to grieve and heal both physically and emotionally.

As you have had surgery you can start taking folic acid straight away, but it is still important to take it for 12 weeks before trying to conceive.

We will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team