Dear NP20+,
I am so sorry to hear of your ectopic pregnancy and loss.
The Trust generally talks about being discharged from care and restarting folic acid supplements after your hCG has declined to below 5 as there are pre pregnancy levels. I am not sure what your hospital trust policy is, but you could find out by calling the EPU or asking the Patient Advice Liaison Service (PALS).
Your periods can take a while to re-establish and they can re-start once hCG levels have fallen below about 100mIU/mL and most women find that their period arrives some time in the four weeks after their hCG levels have fallen to 0 if treated with Methotrexate
If this is your first bleed, after treatment it is a response to falling hormone levels and which involves shedding of the uterine lining and is not classed as a period. The length of the bleeding can vary from woman to woman and some women do report spotting and bleeding for up to around six weeks after an ectopic pregnancy.
As a gentle reminder, if you plan on TTC again, following methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood tests) and then take a folic acid supplement for 12 weeks before you try to conceive. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the “wait” and then taking folic acid for 12 weeks before trying to conceive is so important.
Sending much love,
Karen x
The Ectopic Pregnancy Trust
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