Suspected ectpoic but but HGC levels falling. Refuse Methotrexate?

[Del123]

I was diagnosed with a suspected ectpoic last week. My HGC level started at 1900, nothing was visible on a scan. 2 days later it was 1700, 2 days after that 1500, still nothing seen on a scan so they diagnosed a pregnancy of unknown location or ectpoic.

As my levels are not falling enough they want me to take Methotrexate. However, I had chemo last year for breast cancer and am on tamoxifen, I really want to avoid this drug and am pushing for expectant management. The pregnancy was an accident.

Has anyone got any experience of being expectantly managed with levels this high, though dropping slowly? My hope is that my body is resolving the ectpoic though I am aware I am still at risk of a rupture till levels fall to 0. Would the methotrexate just mean that the levels fall quicker therefore reducing the time I am at risk for? I just don't want to take a strong drug unnecessarily?

Thanks for any insight/advice.

[messtins]

Have no experience of ectopic but didn't want to read and run. I'm sorry you are going through this and facing tough decisions about what to do next. If you don't get answers here I'd try the Miscarriage Association Helpline: 01924 200799 www.miscarriageassociation.org.uk
or Ectopic Pregnancy Trust Helpline: 020 7733 2653 www.ectopic.org.uk

[Del123]

Thanks messtins, those numbers are useful, will give them a call. Had a look on the websites and lots of good info on there too. Thanks for your help.

[Ninjacat]

Hi Del,
Sorry to hear your in this situation.
I had my ep removed under ga.
My levels were much lower but going up and down.
Consultant said that I probably wouldn't rupture but that the pg bumping around in my tube would leave me with damage and increased risk of another ep.
I was offered metho but was also quite wary of the effects. Consultant was happy for me to go straight for surgery and for me this seemed the best of a bad bunch.
From what I understand and I am no expert the larger and longer the pg is in place the more lasting damage it can do.
Is there anyone at the epu/hospital who can discuss your options with you?
Wishing you lots of strength and support,
N

[Del123]

Hi Ninjacat,

Thanks for sharing your experience, sorry you have been through this too. Really helpful to hear you had surgery though, my feelings at the moment are I would rather have the surgery than the drug! How was your recovery? Is it key hole?
The gynaecologists have been through my options, they just seemed very quick to try and get me to take the drug and didn't really listen to my concerns. They agreed to monitor me closely and I have another scan and blood test tomorrow so we will agree a plan then. I think because I have been through chemo last year the thought of having another chemo type drug is really upsetting for me. Really hoping my levels have gone done enough tomorrow.
Hope you are all recovered now, thanks for your input it's been really helpful.

[Ninjacat]

Hi Del,
Hope today goes ok for you.
My surgery was mostly keyhole with a little incision once they found the pg.
It was painful for a few days after but I was back at work after a week (I'm freelance and needed to get paid - should really have taken a bit longer). Also I didn't lose a tube so that may have made recovery a little easier.
I hope they listen to you and realise why drugs might not be the best option for you. It's completely understandable why you would not want them.
Fingers crossed things are working themselves out naturally for you and you get to avoid both options.
My op was back in April. All well now.

[Del123]

Glad you're all recovered now Ninjacat.

Fortunately my levels were still dropping, though I had a very tense 3 hour wait for bloods. They have agreed to monitor me and I don't have another blood test till Weds. All in all a very good outcome! Getting a bit sick of hospitals but relieved to avoid the drug! (hopefully bloods will keep falling). Thanks for all your help.

[Ninjacat]

That's good news Del.
Best of luck for tomorrow.