Not sure which management to choose. Ectopic with low hcg

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1

Hello,

This is my first post and instead of soul destroyingly searching google I would ask for people advice on here.

So basically I got a positive test at 13dpo it was very faint and was slow to progress. GP did bloods on the 18/5 and hcg was 11. Repeated on 22/5 and had risen to 159 (yay I was pregnant).

26/5 spotting started and a bit of coffee ground bleeding.

Bloods done 29/5 and hcg dropped to 70. I spotted for 7 days then on the 2nd, 3rd and 4th had heavier red blood and clots.

Subsequent bloods as follows

1/6 rise to 75 clear scan (just abdominal)

5/6 rise to 79

7/6 (today) rise to 85. I had an internal scan yesterday and with some searching the found a suspicious area on my fimbriae which could either be a cyst or ectopic but they are leaning towards ectopic since they can’t find the pregnancy elsewhere.

With my levels being so low they have said they would support expectant management but on light of them not decreasing and plateauing over the last 9 days they would also allow me to have methotrexate.

I am going back on Friday for repeat bloods and they said they can order the injection for that afternoon.

Any experiences or advise especially with low hcg greatly received.

TIA

2

Hi Mrs Moo

I’m sorry to hear your story, a similar thing happened with me too. I had relatively low HCG levels and was offered both expectant management and the methotrexate injection.

I was reluctant at first to go with the methotrexate and decided to give my body another week of blood tests to see if it would decrease on its own, but unfortunately I had a slight rise and then platoed for the week.

I could have given myself longer, but I was really keen on just getting this all over with and moving on with my life without having to go to the EPU for constant checks and blood tests so I decided to have the methotrexate. My levels were at 0 pretty soon I think it was within 2 weeks. The only down side with having the injection is the 3 month wait to try again. To be fair though I’m 2 months in and it has gone pretty quickly.

For me it was definitely the right decision as it meant I could start trying to move on quicker, so I guess it just depends on you really!

If there is anything else you wanted to ask I am here! xx

3

natashaxox:
Hi Mrs Moo

I’m sorry to hear your story, a similar thing happened with me too. I had relatively low HCG levels and was offered both expectant management and the methotrexate injection.

I was reluctant at first to go with the methotrexate and decided to give my body another week of blood tests to see if it would decrease on its own, but unfortunately I had a slight rise and then platoed for the week.

I could have given myself longer, but I was really keen on just getting this all over with and moving on with my life without having to go to the EPU for constant checks and blood tests so I decided to have the methotrexate. My levels were at 0 pretty soon I think it was within 2 weeks. The only down side with having the injection is the 3 month wait to try again. To be fair though I’m 2 months in and it has gone pretty quickly.

For me it was definitely the right decision as it meant I could start trying to move on quicker, so I guess it just depends on you really!

If there is anything else you wanted to ask I am here! xx

Thank you so much for taking the time to reply. I am so pleased it all went smoothly for you once you decided your treatment method.

Can you remember what your hcg levels were.

I hate the feeling of being in limbo and then so frightened incase it ruptures. I feel like life is on hold xx

4

Dear Mrs_moo,

I am so sorry to hear of your loss.

As we are a charity, we cannot provide personalised medical advice. I would advise talking through all options with your medical team.

In general terms, if hCG levels are low and declining and you are well without any signs of rupture, expectant management is an accepted treatment. If hCG levels continue to rise, methotrexate may be an option.

We have more information on methotrexate on our website which I have copied here which may be useful for you

https://ectopic.org.uk/treating-an-ectopic-pregnancy

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

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

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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

5

Hey

Yes so my levels were:

151

140

180

270 - gave myself 1 more week

325 - had methotrexate

80

20

2

So relatively low levels! I also was worried about a rupture which I guess added to my decision to have the methotrexate, every little twinge I thought oh no it’s happening! xx

6

natashaxox:
Hey

Yes so my levels were:

151

140

180

270 - gave myself 1 more week

325 - had methotrexate

80

20

2

So relatively low levels! I also was worried about a rupture which I guess added to my decision to have the methotrexate, every little twinge I thought oh no it’s happening! xx

Thank you. So they really came done well for you. How were you after the injection?

I have decided that if my hcg hasn’t dropped tomorrow I’m to go with the injection then hopefully get life back on track. That be 14 days since I started bleeding and 12 days since the first blood test. X

7

After the injection I didn’t actually feel TOO bad, I did just feel really tired and lethargic but that was all i noticed to be honest!

Let me know how you get on tomorrow! xx

8

It’s come back at 77 so a 9% drop in 48 hours. It should of been around a 50% drop but consultant wants to wait and have it rechecked on Monday. So another 3 days on limbo. I have a gut feeling it won’t have changed much and it’s just delaying what the treatment and I’ll end up still needing it. But the consultant wins.

It’s utterly pants! There is a risk of rupture until the result it below 5 so totally petrified. Worried about every twinge. My husband is utterly useless! Not seen him for days because silaging is his priority (he’s a farmer)

The unit just keep saying the usual that if anything changes and you feel unwell, have increased pain or shoulder tip pain go straight to a&e xX

9

Ohh I’m sorry to hear that :frowning:

Although they are making you wait until next week maybe you will be lucky and it might drop enough, are you still bleeding? I found that the more I was bleeding the lower my hcg got! I know it’s so so so hard to try and not worry about it rupturing and I’m sure it’s all that’s on your mind, like it was for me, but I think its good to just try and relax as much as possible and not over strain yourself!

That sucks regarding your husband not being around, he should be supporting you! Well even if he is around you have everyone on here for support and me too! I know exactly how you’re feeling and went through exactly the same thing and I’m nearly through it and you will be soon too! xx

10

Thank you.

Once they said it had dropped they initially said it was up to me what I do and I so so undecided. But the nurse went to speak to the consultant and he said he wanted to wait so in a way taking the decision away from me was a blessing. I just hope it isn’t more wasted time however I have done a cheapie internet test everyday since I got my BFP and I do think it has got slightly lighter yesterday and this morning. So who knows I’ll try and distract myself today and we’ll see what tomorrow brings xx

Hubby did take the day off yesterday and we went off for the day which was I nice distraction xx

11

Sorry forgot to say yeah I stopped bleeding there is just the tiniest bit when I wipe. I bleed the heaviest 7 days ago and my levels still increased.

I hope soon I will be at the end of this horrible time like you. I appreciate all your replies xx