Does anybody know why it’s so important hcg declines by 15% between Day 4-7?
My levels:
Day 1 - 1970
Day 4 - 1863
Day 7 - 1713
A 15% drop from Day 1-7 but 8% drop between Day 4-7, which was said to be suboptimal, so had 2nd Methotrexate jab yesterday.
My question is, surely if your levels have decreased from Day 1, this should be taken into account? Especially as its common for hcg levels to rise in Day 4. Surely my levels are better declining over 7 days, than someone’s whose numbers went up then down…It doesn’t feel logical too me…?
I feel from reading that there isn’t actually enough research on it yet and the hospital are just following the set guidelines at the mo which is the Day 4-7 decline but just wondered if anyone had any further knowledge on it? I’m so desperate to avoid surgery if possible!
Dear deerdancer,
I am so sorry to hear of your ectopic pregnancy loss,
The first 4 days of methotrexate are discounted 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 as this is a more accurate representation of how the methotrexate is working for you. If there has not been a 15% drop, this is when the doctors will consider a second dose of methotrexate or surgery.
We have more information on methotrexate treatment on our website here and I hope it helps
https://ectopic.org.uk/treating-an-ecto … thotrexate
Sending much love,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
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