Pregnancy of unknown location: methotrexate or expectant management?

[lotus37]

Have been told I have a pregnancy of unknown location (in my 8th week) and that it is up to me to decide whether to have methotrexate or expectant management. My HCG levels are very low (currently 150 something) and have only risen 7% over last 48 hours. I really don't know what to do and they couldn't give me any real information about the risks of expectant management. No pain, no bleeding at the moment (had a big bleed including clots and tissue at 6 weeks which I thought was the miscarriage). In late 30s so having to wait another few months to try again after methotrexate isn't ideal but on the other hand the uncertainty of expectant management sounds tough. Has anyone had a similar experience and what did you do? Thank you.

[BasalGanglia]

Hi, sorry to hear you're going through this. I had a PUL last year with an hcg level of 5000 at 10 weeks and wasn't offered Methotrexate due to the pandemic so I can offer some insight into expectant management.

I had to have blood tests every few days to start with and then weekly as my hcg dropped. It took about 12 weeks to get to

[lotus37]

Thank you, and likewise so sorry you had to go through this. It's really helpful to hear your experience and timeframe. That must have been a tough wait though glad to hear all turned out ok.

[Susanthepig]

A friend of mine had this decision recently. She decided to wait and it passed on its own, within a few weeks. She was advised it can be reabsorbed into the body?!
She had her hcg checked regularly and a few scans to see how things were progressing.
Good luck. It’s always hard to know what to do in these situations.

[lotus37]

Thanks, yes - I guess I'd be regularly checked if I decided to go the expectant management route too and they'd keep an eye on things. It is hard to know what to do, I keep switching between the two options. Part of me just wants it over with, part of me feels like the drugs are OTT for what I'm presenting with at the moment. I wish the docs would make the decision for me. Argh!

[lotus37]

Just to update, the registrar eventually advised to go the methotrexate route as numbers were still rising. I had the injection yesterday.

[Springandsummer123]

Sorry you've been through this. There's a great thread for TTC after ectopic here, it's really supportive:

TTC after ectopic Part 2 www.mumsnet.com/Talk/conception/4132582-TTC-after-ectopic-Part-2

[lotus37]

Thank you @Springandsummer123 x