When can I try again after methotrexate?

Preparing For Your Next Pregnancy
1

Hi, hope everyone is okay. Currently going through a pregnancy of unknown location, treated with methotrexate (one dose). My HCG levels have been fairly low consistently, but extremely stubborn and slowly rising.

My hcg levels were 450 the date I had methotrexate, rising to 820 by day 4 and dropping to 600(ish) day 7. I’m hoping for a big drop next week but still getting very positive pregnancy tests as of today.

My question is re the 12 week/3 month break we must have following methotrexate as I’m finding slightly different feedback online. Can we try 12 weeks after methotrexate was given, or is it 12 weeks after being able to take folic acid (+ further) supplements again once hcg is at pre pregnancy levels?

Just, based on my current situation I imagine there is going to be quite a few weeks difference between these two scenarios.

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Dear may,

I am so sorry to hear of your ectopic pregnancy loss and I truly understand how frustrating it is waiting for hCG levels to go down following methotrexate.

Regarding trying to conceive, 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 before trying to conceive. 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.

We have more information on this on our website which I have linked here.

https://ectopic.org.uk/physical-recover … eive-again

Sending love love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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