Petrified of Methotrexate injection

[timetostartbeingme]

I'm having a pregnancy of unknown location. I should be around 8 weeks pregnant, bloods been low and slow rising. They dropped but then went back up, last week mon-wed they rose by 200 Wednesday- Fri they only rose by 2.

Nothing at all to be seen on a scan Monday and Friday last week.

My 'plan' is to have methotrexate tomorrow. I'm going to ask wether I could have hcg taken again in the hope that it's peaked now with the very slight increase and that it will go down but even if it does if it's of unknown location will it correct itself?

Beside myself with worry, feel so sick. No symptoms such as cramps or bad pain.

We dreamt of getting these two lines for so long, now I dream of a negative and being able to try again.

Any experience on Methotrexate?

Thanks

I was in your position about 15 years ago. Take the methotrexate - it will hopefully save your fallopian tubes so you can try again. I understand how badly you want it but an ectopic pregnancy is a medical emergency. I was in Ireland and at that time they had to wait until the last minute to end the pregnancy, even a known ectopic. You will have a quicker recovery if you do it sooner. I’m so sorry you are going through this.

Hi thanks for your reply. I think I'm just trying to hold on to the fact my hcg increased by so little on my last test maybe that could mean it will fall naturally.

It's so scary I've read about the side effects, did you have any? Did it affect your fertility ?

we were 4 years trying before the ectopic so my fertility was already not great. We are blessed with two healthy teenagers now. I had a number of further miscarriages but no other ectopic. The injection itself was quite painful but that’s all I remember about it. There were no lasting side effects. I was 9w 3d and they never could tell exactly where the embryo was. My HCG was continuing to increase slowly until the injection.

Thank you for sharing your experience, sorry you had to go through it. Reassuring to know you had successful pregnancies following it.

We have struggled with fertility too, it's a worry having to wait 3 months or 6 if two injections are needed however I fully appreciate 6 months waiting is nothing in comparison as to what could have happened.

They can't locate anything with me either, I just don't understand it.

Is it right you have the injection in your bum? Did you bleed after? I'm just struggling to get my head around needing to pass something that they can't find.

On Monday my levels were 1358 on Wednesday they went up to 15something then only went up by 2 or 3 in 48 hours.

Previous to last week my bloods went 535, 755, 1555 then down to 865. We thought a natural miscarriage but then numbers went back up to 1300

Really sorry you're going through this.

I'd be minded to opt for the operation tbh. I opted for methotrexate but it didn't entirely work. I ended up being rushed in for emergency surgery 2 weeks later as the ectopic ruptured a tube causing internal bleeding.

Be mindful of the fact that methotrexate strips the body of folate so don't rush back into ttc. Due to my circs I was told I'd need to do ivf going forward. We did an egg collection circa 8 months later and all of the embryos were genetically abnormal (we opted for enhanced screening), possibly due to the methotrexate in hindsight.

Hi thanks for commenting.

That's concerning to read, I've not been offered surgery I would need cameras etc first as they don't know where it is. What were your hcg levels?
I've had my ovaries and tubes checked twice now and no sign of anything, they said my follicles look healthy and plentiful. I've got pcos and it's been a long time coming, my cycles had only just got regular.

I am sorry- ectopics are horrible and so unfair but it’s really important you get this sorted.

They can’t find it because it’s squished in your fallopian tube. Your hcg levels are rising slowly because it is not growing properly and at the levels you describe there is no chance of this being a successful pregnancy. If you don’t pass it out your tubes they might rupture and you could die.

One option is surgery- always successful but will involve taking a tube out. You still have another so not the end of the world but then you only have one!

The other is methotrexate which is to try and save that tube to improve your chances of future pregnancy

Either way you can’t just ignore it but your consultant should explain the risks and benefits for you

Hi thank you! Xx

I've known from the start it wasn't a viable pregnancy as numbers have always been low and slow rising.

Would it not be Visible on a scan if in fallopian tubes? Will it pass from fallopian tubes and would it have been anything I've done that could have caused what's happened?

I'm absolutely devastated however I am feeling fortunate to be told my plan is the injection and not surgery. It's horrible worrying so much every pain and niggle makes me so nervous x

I did bleed afterwards like a very heavy period. I can’t remember how long for. At 8 or 9 weeks the baby is still so tiny it is hard to see if embedded in an unusual place. Yes it was 2 (?) injections in the bum from what I remember. I got it late at night and the bleeding started the next day.
I also have Pcos. Wish you loads of luck and be really gentle with yourself.

Thank you, it's been a really hard time. We couldn't believe our luck :(

How long did you have to wait to try again after two injections? Did you have any other side effects of the injection? Xx

I was told to wait as long as the pregnancy (ie 10 weeks) before trying again. And start taking folic acid well in advance. I don’t remember any side effects but think I was already traumatised by the whole experience before even getting any injection. I think it was 2 one right after the other. Then some blood tests in the weeks following to ensure HCG was falling (it did).

I'm anxious around the wait times after, been told three months but then read others have said 6 months if having two shots. I suppose everybody is different and it may depend on how fast hcg goes down etc. Mine was at 15xx on Friday so hopefully it will all go straight forward.

Does this mean my fallopian tube is damaged causing the ectopic? Scared me classing it as a PUL as they can't see anything. As you do, read so many horror stories x

No it doesn’t necessarily mean there is any damage, just that the embryo embedded in the wrong place. Ask at the hospital about wait times before trying again - I might be giving you bad or out of date info there. Do whatever they tell you to do. It depends on how far along you are and how long before HCG is undetectable or <5.

Also do write down all your questions for the hospital and write the answers so you don’t forget.

Thank you so much x

My husband had a low sperm count, he was able to completely turn it around and now this happens!

Hoping we can go on to have a successful healthy pregnancy. Xx

I hope so too 🤞
ectopic pregnancy is a shitty thing to happen and so scary but usually just bad luck. Not to do with pcos or anything you’ve done wrong. Good luck.

I had the methotrexate and it worked fine for me. I would much rather that then surgery! So sorry you're going through this. We had the ectopic after a miscarriage and it's so gutting after being so excited to be pregnant. I hope everything goes well for you x

Thank you xx It has been so hard, I've not been able to take any time to process it either so the only thing I can focus on is hopefully being able to try again xx

@timetostartbeingme hey, just thought I would ask how it went for you? Hope everything is as ok as it can be xx

Hey, thank you for messaging!

Tbh I don't even know what day it is and I've been to hospital so many times I can't remember which days and for what.

I've been back Monday and Tuesday this week, I was told I was having the injection Monday however when I got there they said they rotate doctors and the new one wants me to have another scan and bloods. My bloods have gone down by around 200 and still nothing to be seen on scan. I spoke to the dr Tuesday who said as I'm not in any pain I have three options surgery, injection or to delay treatment to see if numbers go down. I decided to delay treatment and I go back tomorrow evening for bloods if they're not less than 500 I'll go in Friday for the injection. Just done another hpt and it seems just as dark so I don't think it's gone down a significant amount.

Just so fed up and frustrated with it all now. Heartbreaking seeing the couples in the waiting room upset with their worlds falling apart like ours and then the couples rightly so smiling from ear to ear after a reassuring scan. Just exhausted.

Thanks for asking!!

Oh no, this must be so awful for you. I know how you feel seeing couples either so upset or so happy. We had the same thing when we had the methotrexate. I hope everything goes as well as it can, and let us know how you get on if you can. Thinking of you x

@timetostartbeingme
I had the injection 6 years ago, had an ectopic three months after a miscarriage and was devastated.
I still get twinging pain in the location of the ectopic, but no ill effects when I had it...and I also have a four year old DD who was conceived from the ectopic side. I had a private scan that confirmed this.
I waited a year afterwards as I was so freaked out by it and took a ton of vitamins etc.
Ectopics are bloody horrid, massive hugs to you.

@bertfyboyts it's horrible isn't it. What were you experiences with the injection if you don't mind me asking? Thanks!

I just wanted to wish you well.

I have had 2 pregnancies of unknown location and had methotrexate twice. I vividly remember the feeling of yo yo-ing back and forth to the hospital, never with good news.

I felt very down afterwards and found waiting 3 months before I could try again very slow and stressful. It's such a tough time.

But, I went on to have 3 babies, so please know there is hope. As horrid as it was knowing I had to have methotrexate, I was relieved to spare my tubes.

Please be kind and gentle to yourself and I wish you the best for the future.

@Petal7 thank you, and sorry to hear about your PUL. Were they consecutive? I'm so scared of having the same again. I knew it wasn't a viable pregnancy from my first bloods not increasing as they should however I never imagined it would drag on like this and have never heard of a PUL I can't understand where it could be.

That's wonderful to hear about your successful pregnancies, was there much time following you PUL and your successful pregnancies? I'm feeling very fortunate I haven't lost a tube but I'm in that weird place of not knowing what's happening. I'm hoping for a miracle and that my bloods have plummeted however I doubt it and I think I'll be having the injection Friday. Atleast with so much unknown that kind of puts an end to it all (hopefully!).

Thanks for messaging, it really is a lonely place.

@timetostartbeingme

Sadly my first experience of pregnancy was my first PUL, but fortunately I then got pregnant with DC1 the first month of trying once the 3 months had passed!

Then I got pregnant again when DC1 was 10 months old and had DC2.

When DC2 was 9 months, I had another PUL - - the egg was released on the same side as the first PUL (despite no problems showing on scans)

Then I went onto to have DC3 - born 2y3m after DC2. I then had a miscarriage 2 years later.

I'm so sorry you're going through this. You're right, it is a very lonely place and all the worse for being so prolonged. You can't help but hope with every set of bloods and then hopes are dashed. In a way, I felt "better" once I'd had the injection as I felt I was on my way to trying again. I also had early scans with subsequent pregnancies for reassurance.

I'm thinking of you.