Should I have had the methotrexate injection?

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Hello, I’m new here and this is my first post. Just looking for some support.

I had some bleeding around 6 weeks and went for an early scan and blood tests. The midwives couldn’t see anything on the scan and my HCG levels were only at 148. They then dropped to 118 at my next appointment but then raised to 164 48 hours later and was told that it was a pregnancy of unknown location. They raised again to 193 at the next appointment and I was advised that the methotrexate injection was the way to go. My HCG has now risen to 235 at day 4 and I am so worried that I’m going to need a second injection!

I can’t help but think that I should’ve held off on the injection to see if my body would resolve it itself as i’m devastated about having to wait 3 or 6 months to ttc again.

Is anyone else feeling like they should have waited to have the injection or was that the right thing to do?

Thanks in advance,

Debbie x

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Dear Debbie,

I am so sorry to hear of the worrying time you are going through.

As I am not medically trained, I cannot comment on your specific case however if your levels were rising, it seems the sensible option was to have treatment and as your levels are low, methotrexate would be a good option as it is less invasive than surgery, although I appreciate it can be a long drawn out process.

You mention your levels have risen on the day 4 bloods, this is common and 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. Your 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 would therefore wait to see what your next levels are.

regarding ttc, we and many medical professionals advise that if you have had treatment using Methotrexate (whether one or two injections), 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.I

I hope this information helps in some way, please continue to lean on us for as long as you need,

Sending much love,

Karen x

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Hi Karen,

Thank you so much for your response. This forum has been so helpful already.

My Hcg levels were the same today but I have asked to have my bloods done again on day 10 before agreeing to the second dose of methotrexate. I’m not 100% sure that this is a good idea but I would really rather not have the second dose if I can avoid it.

Thanks again,

Debbie x