Waiting instead of methotroxate / surgery- Anyone else?

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1

Hi there,

I found out we have an ectopic pregnancy last Saturday after going to hospital with unexplained bleeding. I actually didn’t know I was pregnant so to find out during a scan was quite alarming. I had a missed miscarriage back in January so sadly I’m familiar with some of the processes.

My pregnancy must be early - around 4 or 5 weeks, and they tested my hcg levels which were low - around 900. Seeing as I didn’t have many other symptoms (no significant pain or internal bleeding) they recommended I wait 48 hours to see if the pregnancy will miscarry on its own. Then on Monday the hcg was down to 600 which is positive in this scenario, obviously I’d prefer to avoid treatment if I can.

Has anyone had a similar experience? Most I’ve read on here is people talking about the injection or the surgery, but there aren’t many cases of expectant management. I’ve read about the side effects of methotroxate and I’m keen to avoid it if I can. I’m back at the hospital for more tests this afternoon.

Sending love everyone out there who’s going through something similar. I’m so sorry x

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I started with expectant management as initially my levels weren’t too high and the ectopic was very small on scan. Unfortunately my levels subsequently went up so I had to have the injection a few days later, but I think if your levels have already started to drop you have a good chance of avoiding methotrexate. Keeping my fingers crossed for you!

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Just back from the hospital and the hcg has dropped again to around 280 so looks like things are going in the right direction for me. Thanks so much for replying, it means a lot. And I hope that things all work out for you too. x

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Dear Cadoline,

I am so sorry to hear of your ectopic pregnancy loss,

Expectant management is a treatment commonly used when hCG levels are low, and the woman of person is stable, not in much pain and no signs of international bleeding and can work really well. As you mention, It doesn’t have the side effects of methotrexate or surgery. There is also no statistical difference between successfully trying to conceive again between the 3 treatment options, which is reassuring.

As long as you have your bloods carefully monitored and they continue to reduce and you do not develop any severe pain or bleeding you start to feel dizzy and unwell, there is no reason why this method won’t work well for you.

We have more information on expectant management on our website which I have copied here, that you may find useful.

https://ectopic.org.uk/treating-an-ecto … management

Sending much love and hope your blood tests continue to reduce.

We will be here for you for as long as you need,

Karen x

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Thanks for your reply, Karen. It’s reassuring to read, and the information on your site is really helpful.

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Hello!

Sorry to hear what you are going through. So I found out last Thursday that I have a PUL and suspected ectopic. My levels were 480, Saturday went up to 500, Monday 668 and today 858. I have been offered the injection on Monday once they have rescanned and done some bloods.

I’m anxious about the injection as I would rather it resolve itself and gradually go down, however it’s likely I’ll have to have the injection as well.

X

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Hi all, I had a PUL on 21st July (6 weeks pregnant). HCG 141.

By 23rd July I was miscarrying (heavy bleeding and clots) and my hormone dropped to 77. In the days following I dropped to below 50.

However it then started to creep back up and a week or so later I was at 151 and ectopic diagnosed. I had the MTX injection on the 8th Aug.

I suppose my body tried to deal with it naturally but cells were retained in the tube and they started to divide again.

Hope it passes naturally for you and you can avoid medical intervention - I asked for scans when my hcg went back up and even though there was a little resistance from the nurse who was adamant they wouldn’t see anything, they did. That’s my little bit of advice really - ask for scans if you need them for peace of mind! Xx

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hi again,

Thanks to both of you for your replies. I’m sorry to read about your experiences, but also reassured to hear similar stories. After 2 more checks at the hospital the rate has stopped decreasing and actually today it had gone up a bit again. I asked for 48 hours more before making a decision, but it’s looking like I’ll need the injection too.

I’m feeling really upset because I thought things were moving in the right direction, but I’m disappointed to learn that the numbers can creep back up after a considerable drop.

I’m sad about having to wait longer before we can try again because we really just want to be parents. And I’m anxious about going through the treatment in case it takes a long time to resolve. Sending love to you all in a similar boat.

x

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Hi Caroline

I’m really sorry you’re in the same boat :frowning:

How are you doing now?

Did you go ahead with the injection? If so I hope it’s not been too rough.

I know it’s hard to have the 3

Month wait from TTC but for me, the fact this had been going on 4 weeks already by the time I had the MTX it felt the quickest way to resolve so the 3 month start could begin. The longer it rumbles on and the stress it was causing just wasn’t worth it xxx

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Hi Caroline,

I am in a similar position. I was diagnosed with a PUL on Monday. HGC had risen from 340 to 420 Wednesday and in the hospital they finally found something very small in my tube which they think is the pregnancy. I also have some small free fluid (blood) in my pelvis which could be normal or could be from a rupture. I was offered surgery or expectant management. I should mention that I have had bleeding for a week now. It peaked wed/thurs with clots and now has settled. My next blood are tomorrow. But I stupidly just did a HPT and I feel like it’s stronger than any of the other positives I’ve had so far.

They have said I can’t have MTX injection because of the free fluid meaning a may have already ruptured so it would be surgery for me. I trying to prepare myself mentally. I’m also a teacher and supposed to be going back to work in a week which is also adding to my stress.

I hope yours continue to go down and resolve itself. Much love xxx