Travelling after methotrexate treatment

Hi all,

After two weeks of investigation, I was diagnosed with an ectopic pregnancy on 6th August and received the methotrexate injection on the 7th. I had little to no side effects after the jab, except feeling super tired, and unfortunately while my HCG levels decreased, they didn’t reduce by the expected 15% between days 4 and 7.

As by this point I wasn’t in any pain or had any bleeding, it was decided that I would continue to be monitored with no further intervention at this point – I was also due to get married on 17th August.

On 15th August, I admitted myself to A&E after experiencing severe pain in my stomach and some bleeding. But after a transvaginal scan, there was no sign of internal bleeding so I was sent home again.

I made it through my wedding day with only cramps and slight bleeding, but the pain returned on the Sunday night and lasted for over an hour. I again went back to A&E and after a 5 hour wait, they decided they would operate the following morning.

Come Monday morning, I am prepped for surgery – cannula in, gown on – then one final scan and blood test show my levels had dropped from 1200 to 600 and there was no indication of rupture, so again I was sent home.

My latest blood test yesterday (21st August) shows my levels have dropped to 400, but the ectopic hasn’t changed in size. I am due to go on holiday on 26th August – driving to Belgium – and have two more blood tests before then. I have been warned that the consultant might advise me not to travel, but I was also previously told that my situation would be “resolved” one way or another by my wedding day.

I’m reluctant to cancel my holiday when I suspect my levels will be very low by that point, I’m not flying, and we could all certainly use the break – for my mental health at least!

Has anyone travelled not long after a dose of methotrexate? What HCG levels did you have when travelling and what precautions did you take?

Thanks in advance,

Grace

Hi Grace,

I am so sorry to hear all of what you have gone through, especially during your wedding time. I will do my best to help with your questions.

Your doctors would need to keep monitoring you until your hCG levels are back down to non-pregnant levels, i.e. below 5mIU/ml. This would mean that you’d need to continue going into the hospital for repeated blood tests to ensure this happens, and it is very important that you attend those appointments. While I do not want to alarm you, there is still also the risk of rupture until hormone levels have returned to non-pregnant levels, and you would not want to risk this happening while during travel. In addition, many airlines would not permit you to travel while undergoing treatment and also travel insurance may not cover you.

Once your hormone levels are back down to non-pregnant levels, you should be able to travel, providing your doctors are ok for you to do so. I would speak to doctors as soon as you can to let them know of your plans.

With good wishes,

Michele

The Ectopic Pregnancy Trust

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