Hi
I was treated with Methotrexate 1st of November. My Hcg levels dropped off to zero on the 12th of December. I have had 3 cycles since then ( I have short cycles of 23-25 days) would it be ok if I start TTC again or I should wait couple of cycles more?. I do not know if the mass on mi tube has been reabsorbed or not. It was still there beginning of January. If the mass is still there, would it increase the risk of a second ectopic?
Thanks
Dear Tere,
I am so sorry to hear of your ectopic pregnancy and loss.
Making the decision to begin trying to conceive is an emotional rollercoaster compounded by our sad loss. You are not alone, we here emotional support whenever you need us.
The ‘reabsorption’ you refer to can take weeks and sometimes months to be complete. I am afraid it can be difficult to be precise because our bodies are all unique and we respond differently physiologically with what is happening. In some instances, the fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink and, occasionally, it may not shrink and will leave a blockage in the tube by way of a small cyst. However, the use of Methotrexate does not reduce the chances of successful future pregnancy, whatever the outcome in the affected fallopian tube. Studies suggest the chances of pregnancy are about same irrespective of type of treatment - Expectant management or medical management or surgery.
It maybe some comfort to know that 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. Importantly early scans avail. 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.
Our usual advice if you have had treatment using Methotrexate (whether one or two injections), is that 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.
As you state it has been over 12 weeks since your hCG levels were below 5mlU/ml, we would suggest starting folic acid suppliments as per NHS guidelines, I have copied them below.
http://www.nhs.uk/conditions/pregnancy- … gnant.aspx
Sending much love,
Karen x
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Dear Karen,
Thanks for your reply. I am taking folic acid since the HCG levels were< 5. I think I am ready to TTC again. I hope everything goes well.
Best,
Tere