No bleeding after Methotrexate

Main Board
1

Hi everyone, I’m new here and so glad to have found you!

I was given Methotrexate on Monday for suspected Ectopic.

I am so anxious with everything that is going on right now. Total rollercoaster ride… Quick run through (in bullet form :see_no_evil:)

:exclamation:22/03 positive pregnancy test (yay!)

:exclamation:02/04 heavy bleed = miscarriage :disappointed:

:exclamation:7/04 bloods taken and Hcg down to 46

:exclamation:09/04 nurse suggests to go to A&E as I noticed abdominal discomfort/tenderness particularly around previous c section scar

:exclamation:A&e don’t see anything on scan but test Hcg which is up to 63

:exclamation:19/04 Hcg up to 107 - Methotrexate injection given - they suspect ectopic but too small to see on scan

:exclamation:Today…no bleeding just back pain :cold_sweat: super worried this isn’t going to work.

Anyone else had Methotrexate, not bleed and it work?

I know it probably seems ridiculous to get so anxious when Hcg are already low but I still feel so panicky. The idea that I may need to have surgery or that there is something else wrong, frightens me. I’m in total panic mode. Sorry :disappointed:

I’ve read somewhere you don’t always have to bleed and since mine is so small perhaps I’ll only get cramping??? Help! I need some reassurance that there is hope despite no bleed.

Any stories welcome!

Thank you xxx

2

Dear Berecca,

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

It is not uncommon for women who have been treated with Methotrexate not to have any bleeding. You should be going back to your EPU regularly to have blood tests which will hopefully reassure you.

Please do not be alarmed 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.

I know it is a nerve wracking time, however Methotrexate works well with low hCG levels so I will keep positive for you that it works well. If course, please seek urgent medical advice with any worsening symptoms,

We will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

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

Take a look at our newsletters 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

3

Thank you so much Karen for your message. It’s really reassuring reading what you wrote. You are right, I am having my first lot of bloods taken since the methotrexate injection so I am preparing myself for a rise and to try not to panic. My next bloods are Monday. Since my Hcg levels were only 107hcg Monday , I hope that they will get to zero ASAP.

I am so thankful to have found this site and message board.

Thanks again.

Xxx

4

Hi Berecca_1384

So sorry to hear about your story, especially as you thought the miscarriage was the initial problem :frowning:

I’ve recently just had the all clear after my injection on the 1st April. I did get bleeding but only after day 4/5, it was heavy and felt like a horrible period then went away after a week. Everyone seems to have a different experience with methotrexate. Like you I was wondering what people’s experiences were but there doesn’t seem to be a one size fits all type of situation. Some women have no bleeding and it works others have loads. It’s all down to your HGC levels so time will tell after your next bloods (though some get a little rise on day 3 then it goes down on day 7)

I’m sure it will be okay, if push comes to shove then they will give you another dose but if your levels were low anyways (plus there wasn’t much on the scan) then I reckon the first dose will be okay. However I’m not a doctor haha.

I hope you are okay and dealing with it all okay, It’s so tough but having this forum has really helped me and I hope it does the same for you :slight_smile:

Good luck!

5

Thank you Esb27 for your lovely message.

I’m so sorry to hear you have been through this :disappointed:. How are you feeling at the moment? Did they say to wait at least 3 months before trying to conceive again? Did you change your diet after taking methotrexate? So many questions :see_no_evil:

I had my Day 3 bloods taken yesterday and they seem to have stabilised. Not up but down by 2 if that means anything :see_no_evil: Thank you for reassuring me. It’s been 4 days since my injection and still no bleeding. Periods are due on Wednesday so it’ll be interesting to see what happens. Really hope the 1 injection works. I don’t know about you, but I really want to put this behind me, although, a part of me feels bad feeling that way :disappointed: my emotions are all over the place.

You’re right, finding this site has been absolutely brilliant. Let me know how you get on and really hope you’re ok :kissing_heart:

Xxxx

6

Tbh i’m feeling absolutely fine. I was lucky I think, I got some bleeding and bad pain around day 4/5 but then after week 2 I felt almost back to my normal self. My levels were 1.8 on Wednesday so now officially discharged. Have called my doctor to get a fertility specialist referral so fingers crossed that comes through in the next month or so. I didn’t change my diet after the injection (I wasn’t told too). I did go off my food a little as I felt a bit poorly but then if anything i’ve started eating lots to treat myself after such a shit time. However now i’m discharged and I can officially do exercise again I’m going to start exercising as i’m feeling a bit gross now from eating lots with no exercise. I will say to you though, do try to get out on little walks, even if it’s just round the block. I tried going on a big dog walk the day after my injection and it was too much (i felt dizzy etc) but after day 7 I felt strong enough to go on little walks which helped me feel good again.

Yeah so they said to wait 3 months after you get the all clear before you start trying again. Also start taking folic acid when you are discharged to build up your folic acid levels and to get your body ready for (hopefully) a healthy pregnancy.

That’s a good sign they have dropped even if it’s only by 2! Your day 7 bloods are the most important though so let me know how you get on with that. I think that’s where they need to see at least a 15% drop (if they don’t they I guess they look into doing another injection). I don’t think you’ll get a normal period, right? As your body probs still thinks it’s pregnant. They say your periods don’t usually come back officially until 6-8 weeks after the injection (though not sure if those timings are 100%, obviously it’s different for everyone)

I hope your 1st injection works okay, I know it’s hard but try not to worry about symptoms and feeling them/not feeling them as everyone reacts differently to Methotrexate. It’s totally normal to feel like you just want to get it done so you can move on, I was the same. But it does get easier with time. I want to get back to trying but at the same time I want to have investigations into WTF is happening as I really don’t want it to happen again (but I know chances are high).

Thanks for your kind words, I am doing okay and i hope you are too - good luck with your bloods on Tuesday - keep us posted, we are always here xxx

7

Hey Esb27

Thank you for your message! So so happy for you!:grinning: how lovely to be back to normal so to speak.

Any luck on getting an appointment with a specialist? I live in France and all the Drs here have said that there’s nothing in particular that causes an ectopic for sure and nothing we can do to prevent it :see_no_evil::weary::joy: great!haha! Having said that, perhaps in the U.K. or USA and Canada may say otherwise.

You’re right, I’m doing the same as you and seeing a specialist On 1st July. This way by us seeing someone that specialises in this kind of thing, it will mean they can monitor us from the moment we know we’re pregnant.

If you don’t mind me asking, what were your Hcg levels when they first gave you methotrexate? How much did they diminish by day 7? I had my day 7 bloods today and they went from 105 on day 3 to 88 today. Apparently that makes an 18% reduction which she said was borderline :see_no_evil: so I’m crapping myself now haha! Next one on Monday and hoping to see it go down by more as I really don’t want another injection :weary::joy: she did another internal scan and didn’t see anything unusual so she was happy with that.

Great to hear you’ve carried on as normal with food etc. I stopped drinking alcohol and stopped having sex for the week (not a fun week :joy:) but I asked today if I could do both, (not necessarily together haha) and she said yes so I am pouring myself a glass or 2 of fizz tonight.

Will be great to hear how you get on. Take care of yourself and well done on getting through this :heart: not a pleasant ride but like you, I feel like I am kind of getting used to this.

Keep me posted Reb xxx

8

Hey Reb,

Nothing has come through yet, annoyingly I missed the call from my doctor to tell me about the referral so they text me but I wanted to know how long it would take them for the fertility centre to call me but I guess I’ll just have to wait. Good luck with your specialist on the 1st July, France sounds a little like they are burying their head in the sand about ectopics haha, but hopefully a specialist will give better advice about the future etc.

I was 1500 when I got the shot then mine went down super super fast. I think I was on about 550 after day 3 then 150 on day 7 then 15 day 14 then 1.8 on day 21. So mine plummeted quickly. I often wonder why but they say that some women are like this so there we go. oh yay that’s a great drop for you!! I think hopefully as yours have gone under 100 now you should be fine and won’t have another injection but obvs it can still rupture so keep an eye out for extreme pain, dizziness or extreme bleeding! I was soooo paranoid about it rupturing but hopefully am out of those woods now. I did randomly start getting little mini pain twinges in my left side right where it was, but I think that’s either my body prepping for my period or ovulation, I have read that you can get little pains around both those times for a while after methotrexate.

Yeah no booze, sex or exercise - so shit haha. I think I had a drink after week 3 in the end as I read it’s only really the first week that you should abstain, but sex I waited until my HGC was at 1.8 and exercise I have yet to do haha (but planning on it later this week). I’m glad you were able to enjoy some fizz, much needed after that ordeal tbh!!

Keep me posted on your journey and how things go with your specialist. Thanks so much, that means a lot - I hope your levels continue to drop. It’s funny, I feel like it’s a bit sad we have to get used to it but in a way, if it helps us cope and be normal then i’m not going to question it.

Ella xxx

9

Hi ladies . Sorry you found yourself here. Did any of you know the measurements of the mass in the tubes. I have been given the injection last Tuesday. Had a big drop in day 4, but today that is day 7 it has risen by 3 units. Im worried, I was offered another shot, or to wait and retest on Thursday. I really dont want another injection so chose to wait but I am scared. My levels are like this

343 ( when methotrexate was given)

143 on day 4

147 on day 7

My mass is around 19mm. Im worried if it would rupture . Of course if numbers not dropping on Thursday I will have another injection . I just hope I don’t need . I have been bleeding on and off since before the injection.

10

I received my injection on the 9th and I only bled a little bit twice. Other than that I havent had any bleeding as well as, I went back a day ago and they told me that my levels went up which is normal. Tmrw is my 4th day and I’m getting my blood work I hope it went down, if not they may have to give me another dose :frowning: