Hi everyone! I recently found out I have a small ectopic in my left tube for which I received a dose of MTX. My day 4 results showed a slight rise which I was told can happen. Nervous for my day 7 results! 
I know you have to wait 3 months to conceive after MTX however if you need a second dose, does this time period increase to 6 months?
Dear Withlovesaz,
I am so sorry to hear of your ectopic pregnancy and loss,
You are right, 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.
Regarding the time to wait before trying to conceive, some doctors (mistakenly) think that because they have administered a second dose of Methotrexate that that they must also double the recovery time for the body. However, even in a second dose of Methotrexate, the dosage is still much lower than for treatment of other conditions and is still metabolised by the body very quickly.
Our medical advice is that, if you have had two injections, you should rely on your blood test results as an indicator of what is happening in your body and wait until your hCG levels have fallen to below 5mIU/mL. You can then restart taking vitamin/folic acid supplements for 12 weeks before you try to conceive.
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
During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.
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