Methotrexate injection & separation pains

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Hi! Looking for some advice/stories

I found out I had an ectopic pregnancy on 15/03 after rising hcg levels and a scan which showed a mass but they weren’t 100% certain they could see the pregnancy, only this mass. (I can’t remember the location exactly that they described) My hcg levels were at around 2790 that day.

I got the shot of methotrexate that day and everything was fine. On day 4 my levels had risen 7% to about 3000 which they had expected, that night I experienced horrible cramping and rectal pressure so called the hospital and was advised to wait it out as this was normal side effects to the methotrexate and was to phone back if the pain worsened. After some paracetamol the pain started to subside and I managed to get to sleep fine.

After day 7 my hcg levels had decreased to around 2150, I am now on day 9 and have had really bad pains in the same areas as before again. The pain was twice as bad and I couldn’t stand or sit or lie down, I was almost sick and felt very clammy.

The symptoms have slightly subsided and now am able to lie in one position with a hot water bottle on my stomach, no longer feeling like I am going to be sick but I am worried that I should maybe get this checked out in case something isn’t going the way it should be!

Any advice or similar experience of waiting it out/getting checked out? I have generally felt fine after the treatment bar feeling exhausted and mildly nauseous.

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Dear bkirsten94,

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

Whilst tiredness, nausea and abdominal pain are all side effects of methotrexate injection, yours do sound pretty severe at present.

Whilst I do not wish to alarm you, there is still a chance of rupture with declining hCG levels and I would therefore advise seeking medical advice, either by contacting you local EPU or calling NHS 111 if out of hours. If the pain worsens or is severe and not settling or you develop any further symptoms such as should tip pain or feel dizzy and unwell, please seek urgent medical advice by attending your local A&E or calling 999 if appropriate.

Sending much love and warm hugs,

Karen x

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