Methotrexate worrying.

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Hi Everyone,

Thank you for everyone sharing their stories as it’s helping slightly.

Found out Monday I was pregnant after experiencing some spotting and abdominal pains. Sent me straight to hospital to get checked. Confirmed I was but HCG was only 66. Had to go back today for more bloods it was now only 88. Had internal scan which confirmed ectopic. They think I’m about 5 weeks and said sac is small… they gave me the option to wait two days to see if hormone levels decrease alone or get the injection. I opted for the injection and had it earlier as I couldn’t face waiting another two days etc.

I’m so upset anyway from this whirlwind of a few days but I’m panicking so much about the effects of methotrexate and I’m so scared of a rupture. If anyone could just give me any reassurance that would be great :frowning: :frowning: I’m terrified.

Thanks xxxx

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Hi Danielle,

It’s a really daunting and scary time I know but try not to panic and worry too much, the fact that your hcg levels are low will hopefully mean it won’t take you too long to get down to being at a level where you are discharged, I was over 3000 hcg and just over 7 weeks pregnant when I had my injection and it took me 4 weeks until I was discharged. I had looked up all the side effects of methotrexate, but I didn’t experience many at all, I was tired but mainly emotionally drained and I felt dizzy on a few occasions but that was it. Just look after yourself, rest up and know you’re not alone and if you do have any concerning side effects we’re all here and you should speak to your EPU unit with any worries you have throughout as well. The EPU unit I was at were really helpful and I highlighted any concerns throughout until I was discharged so they’re there to support you too x

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Hey 19457,

Thank you so much for coming back to me. It makes me feel a whole lot better reading your reply and knowing that I’m not alone through this. The nurses did mention I may get some cramps like what I’ve been getting anyway which I’ve experienced this morning, I’m guessing this is normal? Took some paracetamol and it has eased.

What I’ve realised is that I’m stronger than I think after this week and reading through all these posts we’re all very very strong women.

Thank you again x

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Dear Danielle-B23,

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

I too had methotrexate injection and completely understand your concerns, it is such a worrying time, waiting for blood tests to see if they reduce, but for the majority of women, including myself, that’s exactly what they do do.

You should be monitored closely by the early pregnancy unit with regular blood tests.

Please do not worry as 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.

A few days after the injection, it is usual to begin to bleed and this bleeding can last between a few days and up to 6 weeks.

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.

Methotrexate is at least as good as surgery in terms of subsequent successful pregnancies. This may be due to the fact that medical treatment is non-invasive, whereas surgery may cause some scarring around the tube.

We have more information on methotrexate here-

https://ectopic.org.uk/patients/treatment/

We advise that you do not do any strenuous exercise or heavy lifting whilst your levels are reducing.

Above all be kind to yourself and allow time to grieve, to heal both physically and emotionally.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

The latest EPT newsletter is out now! You can take a look at the Winter edition and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

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

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Hi Karen,

Thank you so much for your reply. It’s been a testing few days ended up in with bad pains on Saturday evening so they kept me in over night but they settled so discharged me Sunday.

Had my day 4 results yesterday and they have risen to 95 from 88. As you mentioned I guess this is normal? Was just told to keep an eye on symptoms. Again still can’t stop worrying. My anxiety is getting the better of me as it’s making me non stop thinking about this ‘shoulder tip’ pain to look out for so convincing myself I have the pain even though I don’t think I have as I’m not experiencing abdomen pains.

Just hoping Thursday brings a positive result and it has reduced.

Again thank you for responding it means a lot.

Danielle x

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Hi all,

Firstly I’m so sorry to hear of other women’s loss and heartache…

I’m a week into ‘expectant management’ at 6 weeks pregnant I was diagnosed with an ectopic pregnancy. unfortunately my levels are not dropping as significantly as the doctors would have hoped. I feel physically well (all things considered) no symptoms other than light bleeding, and I had hoped and preyed I could get through this without much intervention. But I’m due back to the hospital tomorrow morning for more blood tests and an inevitable outcome of needing the injection. (after consultants advice today)

My main concern is the length of time I will then have to wait to try to conceive again. Also the worry that in choosing expectant which has failed and now the injection, that maybe I have damaged myself more than if I had just opted to surgery on day one when it was offered?

I’m trying my very hardest to remain positive, but I’m 35 years old and have been wanting to have a child for a very long time so it’s a growing concern that the longer I wait or the more damage I do the harder things will be.

I’m also not sure of what the implications of this may be to my immune system, and with the current world Coronavirus pandemic… would I be more at risk after this type of procedure?

I appreciate I have asked a lot of questions and would be so grateful for any advice

Thank you, and big love to all of you who are going through this or have done at some stage. X

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Dear GG84,

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

Sadly it is sometimes necessary to have methotrexate injection if hCG levels aren’t falling as expected with expectant management. I am unaware that this creates additional risk for treatment as most women such as yourself are closely monitored with blood tests so any changes can be acted upon promptly.

Sadly I am not medically trained so cannot give you specific advice regarding methotrexate, immunity and coronavirus. I would advise asking your medical team.

We have more information on methotrexate injection here-

https://ectopic.org.uk/patients/treatment/

Sending much love and warm hugs,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

The latest EPT newsletter is out now! You can take a look at the Winter edition and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

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

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Thank you Karen.

I have asked and the health care team I am with are doing their best to help me get the answers. I’m due to have the injection tomorrow, so hopefully I can be reassured and go into this with confidence.

Thank you for keeping this service going during difficult times for everyone.

G x

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Hi GG84,

I hope you’re feeling a bit better. Did you get the methotrexate shot? I’m on day 14 now. Went in for what should be my last blood tests today as hoping my hcg levels are below 5 or even 0.

My only question to anyone who has had methotrexate and experienced dull pain still where the ectopic is? I asked the nurse today and they said it may be my body repairing.

It’s not severe but it’s really getting to me :frowning: is this normal, will it go away? They told me to keep an eye on it. It normally comes on after driving or when I’ve tried walking for some exercise.

Thanks,

Danielle

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Hi Danielle

I did have the shot, I’m only on day 2 I go back for bloods on Sunday.

I do still have the low ache and I think that would be normal for a while? Especially as you are tuning into that area therefore more aware of everything happening?

Tonight it the first time I’ve experienced any extra anxieties about a possible rupture. I think I’m being paranoid but I felt a sharp shoulder tip pain, it has gone now. But I’m now really worrying about it, the last thing I want to do is go into hospital and waste the nhs time. Also hospital is obviously somewhere to avoid right now due to the Coronavirus.

Did you or anyone else have a small or one off shoulder pain that was not what they thought?

I’m other wise relatively well, just tired as usual and bleeding a little but I have been for 2 weeks.

Thanks for any advice

And best of luck Danielle! :smiley:

X