Methotrexate - Third time lucky??

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1

Hi,

I was wondering if anyone has ever had to have 3 shots of Methotrexate? I just has a call from my Dr with the results from my 14th Blood test to say that my HCG levels have gone up and therefore I have to return for a third set of injections. He also explained that 3 is the most they give out and if this one also fails then I’ll need to have investigative surgery.

This all started on the 20th of March when I went to A&E advised by NHS 24 after I rang them about a bleed and they asked about shoulder pain - I had thought I’d just been sleeping funny or several nights. After several scans and blood tests it was conculded I had a miscarraige and needed an evac to remove the remains. 2 days after that my HCG trippled so I was taken back in for another scan when they found an ectopic. I had my first shot of Methotrexate on the 4th of April and another a week later when bleeding restarted and my hormones had failed to drop by the 15% required. It has been going down but slowly and now started to rise again. I’ve been bleeding for over a month and am totally shattered.

My husband works at sea and did come home for a week but we need his wage so can’t aford for him to have any more time off. I have 1 child, he’s almost 5. I had him by section and had a terrible recovery with my wound reopening and getting infected 4 times. On top of all this I am doing my post grad in primary teaching and currently am in a Primary 1 class with my assessed observation due on the 15th (less than 2 weeks time). The Uni have been less then supportive (though I’ve not disclosed why exactly I’ve been in and out of hospital).

I feel I’ve now hit a wall and don’t quite know how to cope. Any advise or eperiance of methotrexate taking so long to work would be comforting.

Thanks

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So i went to the hospital today. Before they gave me any further treatment they scanned me. The ectopic is very visible now as it’s miscarrying so there is plenty to see. The product of the miscarriage is now spilling out of the tube and there is a blood clot there. fortunately the tube is not bleeding at all. I was given the choice to either have this third dose of Methotrexate or to have keyhole surgery for them to try and pull out the ectopic or if that failed remove my left tube all together. Aparently a third dose of methotrexate is very uncommon so there are no stats to say if it will work.

After discussing with the Dr I’ve gone for the methotrexate in the hope it will work this time as I’m so scared by the thought of surgery. I’ve to go back in 2 days for bloods to see what the HCG is doing. If it’s not gone down enough I will be given another 2 days. If not enough improvement is made by then they will operate.

I thought I would be moving on by now but I’m still no closer to TTC again. In fact the Dr advised that with having so much methotrexate I should wait 6 months till we TTC.

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So it turns out that a third dose of Methotrexate is not working. My reults have increased again. Although it’s only 2 days, they don’t anticipate a dramatic improvement by Saturday and therefore I am going in for keyhole surgery tomorrow. The hope is that they will be able to pull out the ectopic as it’s now spilling out of my tube. If that fails they will remove my left tube.

Not the outcome I had hoped for but at least it should be an end to this long saga. If anyone is interested I’ll let you know how it goes. Wish me luck

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I had hoped that today would bring an end to this long 7 week slog.

When I arrived at the hospital they took my blood. When the results came back it showed that my HCG had gone down by 6 points. This suggests the methotrexate might infact work. They understood that I’m fed up of discomfort, not knowing and my desperation to move on from this. however after looking at my scans, they feel that surgery is very risky. I have not ruptured but the pregnancy has started to miscarry and there is clotting (between 4 and 5cm in diameter) around the area. They can’t tell for sure but it looks like my pregnancy and the clots are actualy attached to my left ovary. If that is the case, if they went in to operate they would most likely have to remove the ovary which is a much larger operation and comes with more risks including a huge reduction in my fertility. At 32 I want to avoid this as I want another child. So on the advise of the team of Drs and after phoning my husband who is stranded on a ship in the north sea I have decided to wait another 3 days. If my hormones have dropped 15% they will leave me alone. If not they will operate and I won’t be presented with another choice.

I had been ok when I thought the loss would at most be a tube, not great but still some chance to concive, all done by keyhole and not an emergency. Discovering that it could be an ovary too and at least 6 weeks recovery time has knocked me for six. I just want it all to end. I’m exhausted now.

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Dear Ireland83, I’ve just read your posts and I’m so sorry you’re going through such an awful time. I do so hope that the third methotrexate will work for you. I myself had three shots of it and the third shot worked. You have the added worry that you might potentially lose one of your ovaries. It does sound however that they aren’t certain that the pregnancy is attached to your ovary and even if they do need to operate, they may not necessarily need to remove your ovary as the pregnancy could just be right at the end of your tube. Saying that though, even if in the worst case scenario they did need to remove your ovary, you can still conceive with one ovary and the ovary you have remaining will work extra hard to compensate!. There is a newsreader I read about who managed to have two children with one ovary. I’m afraid I can’t remember her name but I will try to find out and let you know.

Hopefully this will all be over soon for you. I know when I was going through it, it seemed it would never end. I hope you are getting support in the temporary absence of your husband. Take care, and do let me know how you get on. Sarah xxx

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Thank you Sarah123k. It is good to hear that other people have had 3 shots of Methotrexate too and that it has worked. I have started to bleed again (just light) which makes me think its working as I’ve bled throughout apart from when it stopped last weekend when my hormones started to go back up.

Yes my parents have come to stay so I have family helping me out which is great.

You are quite right they have no real idea of what is happening inside until they actually go in and look so we are doing our best to avoid that senario. Also thank you for telling me that people manage to have children with one ovary, takes some of the worry away if that was to happen.

I’m not sure about you but hearing other peoples stories makes me feel less alone. I have no friends or family who have gone through an ectopic so they are unable to give any words of assurance unlike everyone on here who can share thir experiences and show that you do come out the other side in time.

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That’s a good sign that you’ve had some bleeding, hopefully it shows that it’s working. If it gets too heavy though or you feel increased pain, do contact the hospital. There aren’t many of us who’ve had three shots. I think for most people mxt works after one or two shots. I remember having virtually no side affects from any of the injections. It was only about 2 weeks after the third shot that I took my dog for a walk and I found I could barely walk more than I few steps. I was just hit with sheer exhaustion. I don’t think it lasted that long though, maybe a couple of weeks. What I also did, to try to help it work better was try to limit the amount of foods I ate containing folic acid, was to avoid all fruit and veg until my levels had reached zero. I can’t say if it definitely helped, but I thought it was worth a try. After the third shot, I think it took around 3 wks for my levels to go to zero. They didn’t plummet but went down gradually. It was so happy when they did reach zero as the whole thing took over 2 months to resolve.

I remember now the name of the newsreader who had an ovary removed - Kate Silverton. She had her second child aged 43 naturally after failed IVF. You’re only 32 and still very young so please try not to worry about your age.

Like you, I didn’t know anyone who’d had an ectopic and I felt that noone really understood how it felt. I suffered 2 ectopics previously and they left me completely devastated. It does however get easier with time. Most people have a normal pregnancy after an ectopic. I think the fact you have had a child already shows you are able to have a normal pregnancy and hopefully the next one will be. In my case, having had three ectopics, I needed to have IVF in the end. Fortunately it worked first time, at the age of 38 and I’m almost 33 weeks pregnant with a girl.

When do you get your next HCG results?

Take care, Sarah xxx

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Hi Sarah,

I go back on Monday for my next HCG test. Thank you so much for the tip about food, it hadn’t even occured to me to avoid things like fruit and veg. In fact I’d been trying to eat more to stop me feeling so exhausted thinking the iron would help me since I’ve bled so much over the past 7 weeks.

I’m so sorry you suffered so much before getting pregnant. I’m so delighted that you are 33weeks, so not long for you to go now :smiley: I hope the birth is easy (well as easy as it can be) and you make a quick recovery in order to enjoy the early day together as they pass in a blur. Are you all organised? Hope your wee girl is a good sleeper when she comes!

Yes Im hoping that having had a child before means that next time will be ok too. And you are very right early 30s is stil lplenty time. Both my grandmothers had children in their 40s something more unusual in the 1950s than today so if they did it so an I.

Helen

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Hi Helen, how did it go at the hospital today? I do hope that the news was good.

Thank you for your kind words about my baby. I’m not very organised at the moment I’m afraid. I’ve bought the large items - pram, moses basket, car seat and changing table, but I still need to buy all the clothes, blankets etc. I’ll feel better once I have everything, as I feel very unprepared at the moment and I only have 7 weeks to go and that’s only if I make it to 40 weeks!. I’ll take your advice and try to enjoy the early days. I’m going to take loads of photos and buy a camcorder.

I’m thinking of you.

Sarah xxx

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Hi,

Thank you for remembering I had my test. Great news it was down by half and on friday it halved again. So my HCG is now 23 as of friday so hopefully when I go back this friday it will be at 0. I’m so relieved that I hung out for the thrid shot of Methorexate to work and would urge anyone else to wait too.

The wall of exhaustion has now hit me and I’ve spent most of the weekend sleeping and still shattered. Think the eotions have finally hit too and so very sad. I desperately need to loose weight and get back to exercising again as it might make me a little brighter.

Don’t worry about having lots of clothes, people will give you so many as gifts. Sounds like you’re really all sorted. I hope the brith goes well and you aren’t late, the over due wait is dreadful and you get so grumpy, though well worth the wait.

Helen

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Hi Ireland.

I’ve just found this forum. So sorry to hear of your loss. I’m glad that the 3rd shot of mtx is now working for you. What a horribly worrying time for you.

I’m a teacher too and I really think your university and school would be really supportive, understanding and confidential if you told them what is going on. The staff at my school have been lovely. I was off for a while but back now.

I had the mtx shot 13 days ago and it’s working well. I’ve gone from hcg levels of 1475 to 16. I feel like I acted really brave for so long that everyone thinks I’m doing alright but really I’m not. When im alone I can’t stop crying. We were trying for our first baby for almost a year and were devastated to find out it was ectopic because we were so happy and excited. And now we can’t try again for 3 months because of the mtx. I know I need to time recover physically and emotionally but for me I would have liked to have focussed on trying again. I can’t seem to stop thinking about what could have been. And now I’m worried about my tubes and if they could be blocked. I just feel so sad. I expected it to get easier but this is the worst day yet. Sorry for the Pity party on your post.

I really hope you are doing okay. And to reiterate what the previous poster said my mum had an a topic pregnancy and had a tube and ovary removed and still managed to have three more children after. So I’m trying to hold on to that hope. But it’s hard.

Best wishes to you.

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Hi Alohamora,

I’m so sorry for your loss and that you are feeling so down. It is great that you are getting support at work but remember that you may need to take some time off for you. It is great that the mxt has worked so well for you. Take your time before TTC again. The stress of it all can make it harder. Easier said than done I know. Enjoy being together and dont focus on what you are trying to achieve. I know its hard. If you are very worried about concieving again why not make an appointment with your midwife as she might be able to put your mind at ease. I plan on contacting mine as it is playing on my mind that my tubes might be furred up now but we dont know do we.

The staff in the school have been very supportive. Unfortunately the university not so much. I was told not to go ahead wtih my observed lesson but after investing so much time (and the school too) I refused to cancel and the tutor failed me anyway claiming my paper work looked like “it was done by someone who was tired”. I took a chance at sharing my pain in the hope of some understanding and an extention to my placement for it to backfire and wipe away the little self esteam I had left.

I’ve suddenly hit a wall too and cry every day and it can hit at any time. I think its part exhaustion and trying to ignore it all for too long. My husband is away and I desperately need a cuddle and its still 10days till I see him. You are not alone Alohamora, i think the crying and emotions are all part of this painful process of dealing with what we have gone through and the fear of what is to come. Not sure about you but I feel I’ve had to hold it together for everyone else, my husband, my son, my parents, inlaws and siblings as they’ve all been worried about me. I’m sure you are the same and feel that no one other than the people on here really know what we are going through. I hate when people ask if I’m feeling better or have recovered as it’s not like a graze or even a broken leg. Yes the physical pain has finally gone but inside I’m a wreak and am scared to think about it too much as I dont want to be unable to stop crying. I sat in my car in the tesco car park for an hour on friday just crying, I couldn’t get out of the car and have no idea what set me off. Pity fest, hey I’m full of pity so don’t feel you not able to join in, please share it with me.

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Hi Ireland.

Thank you for your reply. I really appreciate you writing back so quickly especially as I wrote on your post about me!!

That’s horrible that your university has been so nonunderstanding. Will you get a second observed lesson or can you repeat the placement at a later date? I did the BEd but I have a final placement PGDE student with me at the moment and she was teaching full time when I was off. So it’s nice to be back just to support her. I know how hard going and hectic and exhausting the PGDE is for people, nevermind going through an ectopic at the same time!!! That must be horrible. I really hope that the university allows you the time to get back on track. If your tutor isn’t supportive maybe you could go to your director of studies?

Yes you have aimed up exactly how I feel too. It’s nice to chat to someone who is going through the same thing. The midwife who was treating me has refered me for a consultation with a fertility doctor so I can ask about next steps then. I was going to ask about getting an HSG to assess the health of my tubes. I’m also worried about having thin lining as that was commented on during the ultrasound. TTC was hard enough but worrying about future fertility after an ectopic is just awful!

Thanks for being here to chat to.

Good luck with the post grad and best wishes for your future TTC endeavours!

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Hi girls, just read all your convo about methotrexate. I had it shot into too me twice but unfortunately I bled internally so they rushed me in. I know what u guys r thinking. I hate my body. Wish it were normal. Feel sooo angry. Cant believe I have lost yet another through ectopic. So I now have no tubes left but everything else is there. I have two children already. Just feel like I may never have any again but people say its not the end of the path. X

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Hi,

Sorry it’s been so long since I was on here. Thank you Alohamora for your kind words. I will resit the whole placement in August though to be honest it’s left me with a bitter taste and no confidence that I have any vague ability in teaching so I’m not motivated to do it and complete but I will as other wise I’ll feel i’ve let everyone else down. I so desperately want to TTC again but my husband is really freaking out and doesnt want to try for any more incase I have another ectopic. Yes it scares me too but what this has all taught me is that my wee family is what matters most and my wee boy is always asking for a brother or sister for company and I love being a mother, it’s the best job ever. I’ve been so happy since I’ve not been at uni and being at home with my boy playing games, baking and cuddles. I’ve now had my first period post ectopic and I’m now more broody than ever. Plus I’m finding it hard seeing so many bumps everywhere and so many friends are having babies or announcing they are pregnant.

I was so tired during the ectopic but now I’m taking folic acid and iron my energy has returned and I can stay awake for more than 4 hours at a time.

Mackenzie, I’m so sorry that you have lost your tubes. I don’t really understand the full mechanics so don’t know what to say other than I’m really sorry for your loss which just doesn’t cover it I know. It’s all our fear that the ability to bare children will be taken away from us, it’s part of our identity and regardless is you have 0 or 20 kids it makes no difference, you feel robbed and inadequate. I guess part of my desperation to concieve again as soon as possbible is almost to prove to myself I’m not a failure and I am still a woman. Can you be referred to a fertility clinic? I was told I could be if I didn’t concieve within a year of trying . It might give you some answers and ease the anger. You are not at fault, there is nothing any of us could do to avoid this but then that almost makes it worse.

Thinking of you both.

Helen

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Hi everyone,

This is my very first time writing on a forum, however I have trawled through many of them in my long TTC journey.

As I am writing this I am lying in a hospital bed not knowing when I’ll be able to go home. They are keeping me here for observations and monitoring just in case I rupture.

After many,many, many years of fresh and FET cycles we managed to get a BFP although it wasn’t my first BFP. I already have a beautiful 5 year old son from 3rd successful IUI. A few years ago I had a missed miscarriage at 13 weeks. So when my nurse called to say I am pregnant but my hcg levels were low I was always thinking the worst.

On the 22nd of June my hcg level was 59 but they kept doubling. So each blood test gave me hope. We went for our 7 week scan on 8th July to be told that there was no sac or anything resembling a pregnancy. That was the start of our nightmare. I have since had 4 scans and NOTHING can be found. ANYWHERE. Not in my uterus, tubes or bowels ( i freaked out when he said the pregnancy could be attached to my bowels. Who would have thought???) But my hcg levels at the time were around 10000.

The day after my first scan my Dr at the time suggested a laparoscopy and if he saw anything in my tubes he would remove my tube. He did and the tube came back all clear. Lost a tube for nothing. After the op I went for another scan. At this stage my hcg levels are at around 17000. Still nothing can be seen anywhere. He checked my ovaries but couldn’t tell for sure if the pregnancy was there. Again he checked my kidney and nothing. That’s when I was diagnosed with Pregnancy of Unknown Location. Had never heard of it.

So from the third scan I was admitted to hospital just in case it ruptures. It has now been 6 days in hospital and we are no closer to finding answers. In that time I have had 3 shots of methatrexate at 75mg each and am having another one tomorrow. So 4 all up. At my highest my hcg levels were at 33000 which is extremely high for mtx treatment but at this stage we have no options left as surgery cant do anything because they don’t know where this thing is. I know it’s not a baby, it’s a growth of something.

I have no side effects apart from soreness at the injection site. No nausea or vomiting thank goodness. I can handle anything but vomiting.

I have blood tests every day. I literally feel like a pin cushion.

To make matters worse, we had booked a family trip to europe for 7 weeks. There is no way I’ll be leaving any time soon. And worse still a few weeks back just after my embryo transfer we found out our precious little dog has terminal and aggressive cancer. That is the worst part of this ordeal. My husband tells me she is not herself and i know she is so unsettled without me. She is my shadow and our strength throughout all our TTC years. I feel helpless and hopeless being in a hospital and not being there to look after my beautiful dog. My son keeps asking when I’ll be home. He is not behaving like he should but that’s understandable.

I can’t stop crying and can’t see an end to this nightmare. All i can hope is that my numbers actually drop. Because they are so high this mtx may not work. I am worried they may consider removing an ovary to save my life.

Sorry for the long rant. I have nothing else to do but sit and wait around to be poked and prodded.

Im so sorry for everyone else’s experiences. Unless you go through it,you really can’t understand the h%ll it actually is.

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Hi all

I have never done this before share my story or my feeling. 4 years ago I found out I was 3 months pregnant after being told I would never be able to have anymore child and to be true I stopped trying. It was a miracle but sadly they told me it was a ectopic pregnancy. My world fell apart. As I had proven doctors wrong and actually got pregnant. They offered me treatment with me Methotrexate which I agreed too. I felt lost and lone with with the love and support of my husband, children and family we got thought it. 6 months later which was 22nd December my birthday I was blessed again with another pregnancy only to find out again it was ectopic. Again I had the Methotrexate. This time I found it really hard like someone was playing games with my mental and emotional health. I couldn’t understand why I was blenses by actually getting pregnant but cursed by it being ectopic. For 3 years I didn’t get pregnant again. January 2017 I decided to have my tubes removed as I am going though with Ivf. And they told me that if my tubes are not removed there is a big chance that i would not have a successful pregnancy. January 26th the operation came and I had done it. I feel really lost even though I know I did it for a good cause. I think it hit me that there is no going back. I’m scared as I’ve been trying to have another baby for so long. I have lost 4 in total as before my oldest was born I had a miscarriage to twin. I do have children 2 health boys and I should be greatful but this is something we all want so bad including my children. Sorry if I’m going on. I’m no good at stuff like his and I have never shared my feelings. I’m hoping to start my Ivf in 2 months. X