PUL and MTX

Hey everyone,

I’m a bit nervous. I am experiencing a PUL.
My tubes were clear and my uterine lining was extremely thick. My fertility team is chalking it up to somewhere in my uterus but way to small to see or find. My HCG 2 weeks ago Monday was a 192, then an 88, another 88, 172, 168 and then 218 I was administered my first dose of MTX this past Tuesday.
Went in for day 4 and it shot up to almost 500. My
Next blood work is Monday. Does MTX work ? With my numbers being on the lower end? I’m so scared. Idk if surgery is option since they did not see anything on all my scans. What happens then?

Hi cskurtz101,

I’m so sorry that you are going through this concerning time. I’m not medically qualified to answer your specific situation, but will do my best to help. We at the Trust have heard that women’s hcg can vary (go up and down) in the early stages of pregnancy. It’s very good that you are being looked after and monitored during this time. Doctors will make the decision whether expectant management, mtx, or surgery is most appropriate for your situation.

During expectant management and mtx, they will continue to monitor your hcg levels until they are at nonpregnant levels, under 5. During this time, as best as you can, please do take it easy. The Trust recommends to avoid heavy lifting and strenuous exercise. It can be difficult to wait for hcg levels to fall and we recommend taking things slowly over the next little while.

It’s also important to continue to monitor your symptoms and to seek care from your A/E or dialing 111, if you are experiencing increased pain, bleeding, or shoulder tip pain. Please know that we are here for you throughout and for as long as you need.

With good wishes,

Michele

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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


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Update- today my HCG was at a 400. It only dropped 41 points since Friday. Friday i received my second dose. I’ll get more bloodwork and scans Thursday. All scans last week were clear. My doctors are baffled it didn’t tank more. Will get a 3rd dose Thursday if I need it.

Dear cskurtz,
I am sorry to hear of your ectopic pregnancy loss and worrying time you are going through.
It is not standard practice to have a 3rd dose of methotrexate. I am hoping that you see a reduction. If not, the doctors may consider surgery, but they will discuss all options with you.
I hope you get more positive news next time.
Sending much love,
Karen x