Hi c_booth97,
I am so sorry to hear you are suffering from this ectopic pregnancy and loss. You are not alone in your experience and feelings; I’ll do my best to provide some reassurance.
The MTX process can take some time, and as each woman is different, there is, unfortunately, no set time frame. We encourage women to prioritize their rest and recovery during these weeks, which means no heavy lifting and possibly taking time off from work. It is very easy to say but so much harder to do.
As you’ve already shared, the second shot of MTX is given if hCG levels do not fall as doctors would like. In general, 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.
Every 3-7 days, beta hCG levels will continue to be monitored to ensure that they are falling appropriately. Most women only need one injection, but in up to a quarter of cases, a further injection may be required if serum hCG levels are not decreasing.
You know your body the best, and while the hcg levels are decreasing, it’s important to be mindful of your symptoms until you reach non-pregnant levels, under 5mIU/mL, as there is unfortunately still a chance of rupture. The symptoms of a deteriorating ectopic pregnancy, which include worsening or progressively increasing pain; vaginal bleeding; shortness of breath; feeling faint; and pain in the tip of the shoulder among others, may become noticeable. If you suffer any of these symptoms you will need to be reassessed. Your hospital would give you a number to contact for health advice if you feel that anything is changing, or you will have been told to report to the Accident and Emergency Department (A&E). If you have not been told what to do and need to speak to someone ring the hospital department which is treating you or the NHS 111 Service by dialing 111.
From the bottom of my heart, please be kind to yourself through your recovery. We are here for you whenever you need it.
With good wishes,
Michele
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