Rollercoaster ride - ectopic, fibroids, mtx

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Hello all, just wanted to share my story of this ride which seems to be a nightmare that is continuing.

28 Sep - I went to the GP with bad abdominal pains I had not felt before and fever. Turned out I was pregnant but due to the pain, they sent me to get a scan. No sac found except for mass in tube so suspected ectopic. HCG was 1123 so they said my large fibroids could be hiding it.

30 Sep - HCG doubled to 2254 so they did another scan. Still nothing in uterus except for mass in tube. Since HCG was doubling as per a viable pregnancy, they gave it the benefit of the doubt and said will wait another 2 days.

2 Oct - HCG dropped to 1754. They tried to arrange for a scan but Sunday so didn’t get it organised.

3 Oct - scanned again. Mass in tube had grown to 1.4cm, nothing in uterus. Confirmed it as ectopic. Agreed to inject me with Methotrexate (MTX) although it was a lower dose as my liver enzymes were elevated.

7 Oct - Day 4 post MTX level increased to 3348.

10 Oct - Day 7 post MTX level increased to 3376. Since this was an increase, I was expecting a scan or second dose but the doctor just said wait and see.

This has been an awful rollercoaster ride. They admitted me in the hospital since I was having a fever and abdominal pains as they suspected other issues like appendicitis at the time too.

My husband was traveling overseas on a work trip at the time so I had to let my parents and sisters know. Parent ‘helpfully’ took the opportunity to let me know I had waited too long and should have tried to get pregnant when I was younger and not now. One sister ‘helpfully’ had a rant at me for not opening up to them to tell them I was going through all this.

Luckily husband returned from work trip on 1 Oct so has been very supportive. Unfortunately no end in sight yet for this.

We have been living in Singapore for the past 7 years and were planning to return to London in mid October. With this ectopic, our life goes on hold as well. I can’t travel yet, don’t know when I can, IF this treatment works, our tenancy ends in October. We have a dog and it is difficult to find temporary accommodation that is dog friendly here. I had been made redundant early in the year but was waiting to move to London before starting a new job. Now that is on hold too. I can’t exercise so putting on weight.

Not to mention I have not even begun to process all the emotions of becoming pregnant after trying for ~2 years at 40 but then it turning out to be ectopic.

Thanks for reading if you made it this far.

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Dear L1MBO,

I am so sorry to hear of your ectopic pregnancy loss,

We are a UK based charity it is difficult to comment on follow up on procedures around the world.

The hCG level often rises on the day four blood test because the action of methotrexate is not instantaneous, so the cells will have continued to divide for two or three days after the injection was given, and some cells release more hCG when they start to disappear. In the UK, doctors are looking to see a drop in your hCG value of at least 15% between days four and seven. If there has not been a 15% drop, this is when the doctors will consider a second dose of methotrexate or surgery. I hope you have been reviewed again as if you had a lower dose of methotrexate and your hCG numbers are increasing, I would be concerned.

Although I do not wish to alarm you, if you experience any worsening bleeding, abdominal pain or feel dizzy and unwell, please seek urgent medical advice.

You also sound under a lot of emotional pressure at the moment with an impending move and concerns over housing with your dog and looking for employment. It’s a lot to take on without the added trauma of an ectopic pregnancy. Although well-meaning, I found my friends and family didn’t truly understand the impact an ectopic pregnancy brings from the diagnosis of a life threatening emergency to reduction in fertility and the loss of a much wanted baby. You are among friends here who understand all of this so please continue to lean on us for as long as you need.

Sadly there is nothing we can do to prevent ectopic pregnancy and I must emphasise from the bottom of my heart that you are not to blame. If you are moving back to the UK, I would suggest seeking medical advice if you have not successfully conceived after 6months.

The chances of a further ectopic after a first in UK is 10%. So that’s 90% chance of the embryo being in right place next time. If you do concieve it is important to get an early pregnancy scan to exclude another ectopic pregnancy.As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.

Making the decision to begin trying to conceive is an emotional rollercoaster compounded by our sad loss. Again, you are not alone. We here emotional support whenever you need us. There is a specific Preparing for your Next Pregnancy board you can look at too whenever feel ready.

For now be kind to yourself and allow time to grieve, to heal both physically and emotionally. We will be here for you.

Sending much love and warm hugs,

Karen x

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