Hello everyone - After experiencing an ectopic pregnancy in early September 2022, and having used this forum many times to rationalise my thoughts and feelings, I wanted to share my experience in the hope that I may also help someone else in the process. I was approximately 5.5 weeks pregnant when I noticed some light vaginal spotting having just returned from a holiday. I was pain free at the time but nonetheless felt concerned. I contacted my GP and after a lot of gruelling was referred to EPAU where I had my first scan. I was informed that I was ‘most likely’ carrying an ectopic pregnancy in the left fallopian tube. I felt initial shock and denial that I could possibly be diagnosed with something like this. My previous pregnancy was conceived naturally and I had no known risk factors. I wondered if they had made a mistake. My initial hormone blood test was 1117 and I was given the option for expectant management, medication or surgery. This is what I opted for as I was not keen on medication or surgery at this point. I returned to EPAU a few days later. My hormone level had increased to 2066 and a scan had shown the the ectopic embryo had developed further. I had also developed a ‘muscle strain’ feeling in my left groin and the bleeding had increased slightly. I was informed that expectant management was no longer an option and I would have to consider medication or surgery. I felt worried and frightened and had a million questions running through my head. I felt I needed at least the rest of the day to process my options and returned home armed with patient information leaflets. I sat down that evening deliberating what I should do. My husband was a great source of support and listened to my concerns. The following day I received my first dose of methotrexate and returned home worried about what side effects I may develop. I remember a short burst of intense left sided pain 2 hours after the injection which settled on lying flat for an hour or so. I also noticed that the bleeding had ramped up a notch. In hindsight this was the methotrexate working so to speak. Over the following weeks I found it extremely difficult to figure out whether the symptoms I was getting were due to the methotrexate working versus tubal rupture. I noticed intermittent rectal pain, heavy bleeding with clots, bloating and tiredness. At times the pain led me to want to lie down in bed for an hour or two. I remember speaking to EPAU about my concerns and was advised to ‘come in if they symptoms got worse.’ The constant worry of a tubal rupture is what I have found most difficult and something I am pleased to leave behind now that my hormone level is within the normal range. It has taken 9 weeks for my hormone level to drop to normal since having the methotrexate injection, and I have been thankful to have been off work during this time to help with my recovery. Although the staff on the ward have been extremely helpful and friendly in the earlier weeks, I have found that overall patient education has been poor. I have received mixed messages regarding how to safely start folic acid prior to conceiving, when to expect my period to return, what happens if the bleeding and pain continues and when can I go back to wearing tampons (for example). I have been discharged today with little information and feel slightly lost about what to expect for the future. Needless to say, I am thankful to have finally come out the other side and feel deep sympathy for any woman who is going through, or has been through, the loss of a child. Thank you for the support you have given me throughout my ectopic pregnancy journey.
Hello. Thank you so much for writing about your journey. It really helps to hear others experiences and how things worked out. I recieved methotrexate 5 days ago and was quite suprised that the Dr told me I should not be left alone until my hormone levels have reduced to non-pregnant levels. Obviously I understand that this is due to the risk of rupture so I have had to ask my mum to come and stay with me. I was just wondering, as you were able to take 9 weeks off to fully recover, were you advised to be supervised during this whole time? I know decreasing hormones can take a long time and I am lucky to have support however I’m not sure my mum would want to stay for that long! Were you advised as to when the risk of rupture had decreased?
I hope you don’t mind me asking you these questions.
Thank you x
I am so sorry you are going through this difficult time and more than happy to try and answer your question. The risk of rupture remains for as long as the hormone levels are raised (i.e >2 at my local hospital). Even if your hormone level is reducing, you can still rupture. This is why the fear of rupture never left me and I had a hospital bag pre-packed, just in case. For the first couple of weeks, when my hormone levels were very high, my husband and in-laws were around. After that my husband returned to work and I rested as much as I could, avoiding anything that could raise my abdominal pressure. I made conscious decisions to always have my phone nearby and to keep outdoor walks short. I stopped running and tried my hardest to avoid picking my toddler up if I had someone else around. I would avoid pushing myself too far as I noticed a flare up of pain when I did too much. I guess its a very personal decision and how you feel about the situation x
Thank you for your response and for your kind words. That’s really good advice, I guess we really can’t rush the recovery process or underestimate the impact this has on our lives. I am so used to living in a fast paced world of quick fixes but need to make sure I take this slowly. Thanks again x
Hi did your hcg drop to normal levels themselves ? How often did u have ur bloods done and how fast did they come down?
I had the injection 4 days ago and they have come down by 52%.
Hi Emma - my HCG levels began to drop after I had the methotrexate injection. It took 9 weeks for the levels to reduce to normal. I had my bloods done weekly!
Hello thanks for your reply ! I’m down to 296 (as of Monday) back in Friday for more bloods, such a long process hope your feeling a lot better now xx
How long did you find your pains etc lasted ? The whole 9 weeks? I’m now 13 days post mtx and still getting some pains it’s so hard not to worry it’s rupturing xx
Hi Emma - it is such a worry and useful to hear others experiences. My pains lasted pretty much the whole 9 weeks. On and off and worse when I had a busy day. Thankfully the pains have eased and I can only feel a slight twinge on my ovulation days. How are you feeling? Hope the HCG is coming down nicely x
Hey yeah it deffo is ! My pains eased and bleeding has practically stopped thank god. My levels as of today are 12! I got the mtx 4 weeks ago tomorrow, I’m back on Friday hopefully for the last time 
x x
Hey Emma!! 12 already?! That’s amazingggg! I’m so happy for you! I wish mine would drop this quickly! I get discharged when it’s below 15, what have they said to you regarding next steps?
My doctor said:
Discharged at HCG 15
2 weeks later I take a preg test, if negative, no action and if positive go back in for a scan
If negative, my period should return 6-7 weeks later
If it doesn’t arrive, go back in for a scan
If it arrives, we are all to assume the mass has gone, and life just resumes, once I’m past the 90 days post MTX (for me 27th Feb - marked in my diary!!) then I can try again!
Heyy! Aww thank you so much, that was Wednesday, it was on the ward I was seen and I had a scan too where they said they couldn’t see any mass only a cyst on my left ovary, so I’m assuming that means the mass is away and just a small cyst left ! Not entirely sure tho, I’m back in tomorrow morning to EPU for my routine bloods so I’m hoping they’ll discharge me, I think it needs to be <5 ! And I’m not sure on any follow up I’m assuming they’ll let me know tomorrow, the dr did say I’d probs need another scan in a while to check the cyst out but that was it really! But I’m deffo gonna ask tomorrow just for some peace of mind, as much as I am hoping to be discharged and to finally be able to try get back to normal, back to uni the gym be a proper mum for my wee girl etc, I also will feel a bit sad as that means it really will be the end and there will be no baby 
which is a bit disheartening but honestly I’ll also be glad to have my health and to have avoided rupture etc (touch wood) it deffo hasn’t been a great end of the year, here’s hoping for a better 2023 xxx
I saw your ‘confused’ post on here and tbh, I’m completely confused too… so this cyst was on the right ovary and now the left? Did you have a cyst and a mass then?
I hope today goes well, keep us posted on your bloods! They’ll defo be below 5! I am sure of it!! And you’ll be discharged in time to start fresh for 2023 and put this crazy year behind you.
I know it’s been bizarre this whole month, praying it’s shrinking each week seems so wrong.
It is what it is and 2023 will be better for both of us!! Xxx
I honestly have no idea ! I’m sure I read somewhere that sometimes a cyst can be left where the mass was so maybe that’s what has happened ! I’m sure I’ll be in for another scan to check the cyst tho!
Also the nurse just called me and my levels are at 5 which means I’m now discharged from the ward ! Can’t believe it feels like it’s been forever and now it’s all just over and I can go back to normal life !! Xxx
Congratulations gorgeous! I’m so happy for you! Happy new year xxxxxx
Thank you so much! Keep me updated on yourself I’ll be checking in! Happy new year here’s hoping 2023 is better for us allxxxx
Thanks chick!
I now have the flu, can’t catch a break 
2023 has got to be better!
HAVE THE BEST ONE! xx