The reason behind the 3 month wait after MTX

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1

Hello!

Me AGAIN! (I live on this forum at the moment!)

I am now 10 weeks post MTX shot and my 90 days is up on 27th Feb. The doctors advise 3 months before trying and on here you advise to wait 3 months from the point your HCG levels hit non-pregnancy levels to build up the depleted folate.

But are both reasons for not trying sooner because of depleted folate or does the MTX poison the baby in other ways?

I’m feeling so impatient, the only thing that makes 2023 seem worth it is the hope that by Xmas I’ll be holding my newborn baby or be about to pop! That can’t happen unless I get pregnant very soon :frowning:

I am almost 5 weeks since a negative pregnancy test and still no period so I don’t want to start trying until I feel my body is functioning normally anyway, but I just want to understand the science behind the wait!!

Also, can I just take 2 folic acid tabs a day??

Thank you in advance :slight_smile:

Xxx

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Dear Elephant,

Never apologise for asking questions on these forums, we are all here to help and support.

We and many healthcare professionals advise to wait until your hCG levels have reached pre-pregnancy levels (your doctor will tell you when this is) then take folic acid supplements for 12 weeks. 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.

This also gives chance for your body to recover from the ordeal of an ectopic pregnancy, it gives your periods to return to a more normal cycle. This can be key when dating possible future scan dates.

I haven’t seen any evidence on doubling the folic acid dose, but as methotrexate can affect the quality of cells for up to 3 months, I would suggest taking the folic acid for this time, rather than double dose for a shorter amount of time.

I genuinely understand the desire to conceive, however we would advise doing this safely and also not putting too much pressure on yourself.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

3

Hi Karen!

As always, thank you so much for taking the time to respond! :slight_smile:

I can’t help but put soooo much pressure on myself it’s driving me crazy! Basically if I don’t get pregnant in March or April then I have to wait to try in July 24 (after my wedding) so I’ll be 33 by the time I have my first child and my partner will be 37. I have read all the stories about people who try and don’t get pregnant and then they ‘give up’ and stop focusing on it and it happens naturally but I don’t have the luxury of time at the moment and it’s stressing me out/upsetting me :frowning:

I know loads of people with accidental pregnancies, some at a very young age, who never even heard of folic acid and had perfectly happy beautiful babies. Do I have lower folate than the average person right now then? Or do I have normal levels but I need folate to help heal the egg quality?

Also they say 90 days but I assume like 85 days would also be ok? It’s close? Or is it specific to 3 months?

To be honest, I don’t know why I’m asking all these questions, my fiancé and I have had sex once since this whole ordeal and the whole thing was so traumatic, I couldn’t get the images of all the vaginal scans I’d had the previous months and then that reminded me of the loss and I ended up just crying!!

So I guess before I even talk about this planning for a baby business, I need to nail the actually having sex part! :smiley: :smiley:

Thanks again as always! Xx

4

Dear Elephant,

The methotrexate lowers folate levels in your body, you therefore need to take folic acid supplements for 12 weeks before trying to conceive to ensure your levels are back to where the need to be for a healthy baby.

The thought of having sex again can be really overwhelming after such a traumatic event. It may take a while to feel comfortable. When this is is different for everyone. Speak to your partner about how you are feeling. Also, perhaps explore other ways to be intimate initially until you feel safe and comfortable to have full penetrative sex again.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team