Ectopic pregnancy - larocoscopy or methytrexate?

[ditzy1]

I started a thread last week when I had a scan and they couldn't see anything. To cut a long story short I have bloods on Friday and Sunday and the levels had risen but only a tiny bit and I have been bleeding since Saturday. I had internal and external scans done yesterday and still they couldn't see anything so more bloods were taken.

My questions is this, the consultant has told me this afternoon my blood results will be back and if they were the same or have gone up I will need to go in tonight for a larocoscopy tomorrow. However I know you can have a shot of methytrexate which saves having surgery but they don't do it at the hospital I've been to but they do it at another local hospital.

What is the best course of action? I know the shot hasn't been around long? Is it safe? Long term side effects etc? And I also heard that it sometimes doesn't work and surgery is still needed but it preserves the tubes better?

Just terrified and need to know what to do by this afternoon! Any help would be so much appreciated!

Ditzy, I'm so sorry you are going through this, though I don't know which is better and hope someone will respond soon. I had an ectopic scare exactly a year ago, but it was only a missed mc which bled for 2 months! The worry the docs put me through was more traumatic than the actual mc.

My friend in the US had 2 ectopic pgs last year, and had the shot with the first, and the surgery for the second.

Here's hoping your hcg levels have gone down and you won't need to go in tonight.

Sorry again, but I found this link to an Ectopic Pregnancy Trust, which you may already know about, and it lists the treatment differences: www.ectopic.org.uk/index.php/patients/treatment/medical-treatment-methotrexate/ . They have a number to call, though I don't know if they advise!

Hi Ditzy,

Sorry to hear you're going through this. I had an EP last Feb. For me the laproscopy was the best option as it allowed the surgeon to check that my other tube wasn't damaged, before removing anything. Had I had the injection it would mean that the damaged tube was left and the risk of a recurrent EP higher, according to the Doc. If both tubes had been damaged they would have left everything in place and given me the injection. So basically they look for the best option to preserve as much fertility as possible.

After either the injection or the laproscopy it's recommended you wait three months before TTC again. You'll find lots of support and advice on the link ckny1 has given you.

Hi Ditzy1,
I had an ectopic pregnancy January09' and was offered both aswell. l opted for the methotrexate injection as it doesn't really interfere with anything inside your tubes it just clears all blockages. lt does have side affects but they are not too bad, l had slight nausea and was very tired for a few days but that was about it, my dh thought l would have hair loss etc but l think that is just him overreacting. lt is your decision to make so take your time about it, you'll know yourself what the best option is. Funnily enough, after 6 months l fell pregnant again and all went fantastically well l personally think this was because they inblocked everything. l had 2 mcs before my ectopic pregnancy. l have a beautiful 8 month old dd who is very healthy and driving me slightly nuts. Very best of luck l hope this helped a bit x x

Hi, I really recommend the Ectopic Pregnacy Trust website, tons of advice on there and the forums are also amazing.

I had an ectopic pregnancy this time last year. In my case they thought the embryo was attached to one of my ovaries, rather than in the tube. As I had low HCG levels they opted for methotrexate to treat me. They will only use it if your HCG levels are below a certain point.

Personally it was a much better option for me considering the location of the embryo, my hormone levels, and recovery. Even if it had been tubular, I think if methotrexate was on offer I would still prefer this as you avoid surgery. I was utterly exhausted for 2 weeks afterwards and had 3 weeks off work in total. If you do go down the drug treatment work be prepared for this. Some people feel physically fine, some people feel exhausted. Mentally you probably won't want to be anywhere near work anyway.

It took a while for my hormone levels to go down to 0, I think 4-5 weeks. You have to have regular blood tests during that time to ensure they are going down. At one point they considered giving me another shot as they weren't falling fast enough, but luckily it started to speed up.

I then had to wait 3 months from my first period before conceiving again. It felt like a lifetime at the time, but mentally it helped me get past things and deal with the emotional impact. And just so you know there is hope for the future and having a successful pregnancy next time. You are slightly more at risk after an ectopic, but the odds are still on your side. In my case I'm now less than 4 weeks from giving birth.

Definitely check out the EPT website, it's a wonderful place. Good luck.