Dear ma hari,
I am so sorry to hear of your ectopic pregnancy loss,
In the UK, we would monitor your blood hCG levels every 3-7 days until they reached pre-pregnancy levels, which is generally below 5. Although methotrexate works well for most, it sometimes doesn’t work and hCG levels can begin to rise. I do not wish to alarm you but sadly with medical treatment, there is a risk that your fallopian tube could rupture causing internal bleeding and this can happen even with low or declining levels. We therefore advise to avoid heavy lifting or strenuous exercise of anything that would increase intra-abdominal pressure such as sexual intercourse, until your levels have reached pre-pregnancy levels
With regards to trying to concieve, it is important to use additional contraception such as condoms as we and many healthcare professionals advise to wait until your hCG levels have reached pre-pregnancy levels (your doctor will tell you when this is) then take folic acid supplements for 12 weeks. 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.
This also gives chance for your body to recover from the ordeal of an ectopic pregnancy, it gives your periods to return to a more normal cycle. This can be key when dating possible future scan dates.
We have more information on methotrexate treatment on our website here-
https://ectopic.org.uk/treating-an-ecto … thotrexate
Periods can take a while to start, following Methotrexate your period will begin, in average, at some time in the four weeks after their hCG levels have fallen to below 100 mIU/mL.
If you have any concerns about the level of care you are receiving, I would certainly speak to your medical team.
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
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