I was treated with one injection of methotrexate in May 2020 after having a confirmed pregnancy of unknown location. I was discharged on 19th May having confirmed my HCG had dropped to 2.
I wanted to ask when I can start taking pre-natal vitamins as I want to start trying again in August which will be 3 months after the treatment? I was taking 5mg of folic acid for a slight deficiency that I had to stop for treatment so I will be getting a blood test to check my levels before we start, but ideally I would like to start taking pre-natal vitamins as soon as possible but the guidelines are not very clear.
I had a methotrexate injection last December, and I started taking folic acid a few days after I was discharged so you will be fine to start taking folic acid now if you were discharged on the 19th May. They advise you to take folic acid for 3 months before trying again after being discharged, this is what I did. I actually waited a few more months just due to covid-19 but we are trying again now.
Thank you so much. I have found it really difficult to get information regarding methotrexate, my doctor couldn’t even give me guidance on what I can or cannot do, was told to stop drinking for 3 months and to avoid the sun, then 2 months then told last week it was okay.
Is the 3 months in case you folate levels are low? The nurses I saw have said we can start trying in August but I will start the folic acid tomorrow and see how we feel. I am having a blood test on the 19th June to check my folate levels anyway so if they have been affected I will find out sooner rather than later.
It’s nice to talk to people and get proper advice but sorry to hear everyone having this experience!
I was told to not drink for a few weeks, I was careful until I was discharged but I did have a few over Christmas! I think they say to be a bit careful until you’re discharged as the liver has to work hard to metabolise the methotrexate. I wasn’t told/haven’t heard about avoiding the sun though, although I guess mine was in winter. This website gives some great information!
Yes that’s right the 3 months is to build your folate levels back up, and also I think just to give your body time to do it’s thing and recover… I found that my first cycle was a bit different but by a few months it was back to normal. I didn’t have a folate test through the nhs but I did get a thriva home blood test and did that back in April which included a folate and liver test and they came back fine.
Also just in case you get the same, I found that I had some ovulation twinges on my ectopic side and also would get these same twinges when on my period at time’s. I’ve read that lots of people get them, and some for years after so don’t worry if you do. Again people also say that they get these when pregnant, I think you also just become so in tune with your body after something like this so probably feel everything more.
I had a couple of glasses of wine last week but am still trying to take it easy as you just never know. I was quite lucky that my levels were so low the treatment worked quickly.
I don’t know if you feel/have felt this way but I go from being quite chilled and level headed to extremely worried, impatient and frustrated at having to wait and not knowing whats going to happen next time and how long it will take and worrying that being stressed will make it worse which stresses me out even more!
Thank you for that advice, I would have probably worried about getting the aches. They thought it was on my right/in my right ovary but couldn’t find anything when they looked so it’s a weird one. I haven’t had a period yet but I have had some aches this week so not sure if something is happening.
Hope you are doing okay to, it’s a stressful and scary time as it is without having to go through all this.
Yes it’s definitely been a rollercoaster of emotions the last 6 months, I have been the same, very level headed at times and other times super anxious. I tried to be as positive as possible when it happened, but it’s also important to feel it and let out your emotions, put yourself first and take care of yourself. It’s completely normal and understandable to go through the range of emotions.
I initially felt very frustrated at having to wait, all I wanted to do was to try again but once I was discharged and taking folic again, I felt better as that was my focus as I had the 3 month countdown goal in mind. I’ve struggled the past few months since getting to that milestone and i’m pretty anxious at the moment with everything going on and making the decision to now trying again. We’ve had our first ‘try’ earlier this month and i’m analysing every ache, pain and twinge - I totally understand where you’re coming from, the unknown is hard and I too have been worrying that the worrying won’t be helping! All you can do though is do what you can, take the supplements and follow the guidelines that they advise before you try again (easier said then done though, I think about it all the time). It’s so hard, lots of my friends are pregnant and it feels so far away at the moment. Trying to remain positive with the stats and what I do know is that when it hopefully does happen I am going to be so appreciative! X
I am so sorry to hear of your ectopic pregnancy and loss,
We and health professionals advice when your hCG has fallen to pre-pregnancy levels to start taking 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
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