Ectopic just confirmed :( Methotrexate or surgery??

[landrey]

Hi all. First time on a forum... I'll try to keep this brief.

Have had a rollercoaster month after finding out I was pregnant for the first time a few weeks ago. Within days I started bleeding heavily. Was referred to the EPU and told an early miscarriage was 90% likely. Anyway, back and forth to the EPU I've been over the last couple of weeks- my HCG levels were rising but no pregnancy sac could be found. This morning at 7 weeks 2 days, they can finally see the pregnancy sac in my right tube.

Naturally I'm devastated. With all the uncertainty I hadn't let myself become attached to the idea of having 'a baby' but now I'm feeling very doom and gloom about future pregnancies and fertility. But the big question- what treatment to have?? I've told the doctor I'd rather not lose a tube so am going back in tomorrow for the meth injection, but now coming home and reading further in to it, I'm wondering whether surgery would be more conclusive?? I just want whichever treatment will give me more chance of a successful pregnancy next time.

Would love to hear from people who had ectopics first time round and the kind of treatment they opted for? And also of positive pregnancy stories following this horrible thing. I'm 29 and a week ago my HCG was 2400. Waiting for today's blood results which may make the decision for me but in the meantime I'm very confused!

landrey v sorry to hear that. No personal experience of an ectopic, but you should get the help you need from this thread on the miscarriage board and the board in general is very supportive through pregnancy loss of any sort.

Hi there, I'm so sorry for your loss :( I am 22 and it sounds almost identical to the one I had last Summer, first pregnancy and weeks back and forth to EPU after first being told the pregnancy was a miscarriage (also had a subsequent twin in uterus) then finding out it was infact an ectopic.

It really depends the extent of the ectopic and any damage it has done what route would be taken. I had the meth injection and then twice weekly appointments to monitor how my levels were dropping. My ectopic was caught at about 6 weeks, I did have severe pain and bleeding but I was still able to be treated without surgery which I was glad for. I would really recommend the meth injection before any type of surgery as damage to the tube is much less likely. If you have surgery its likely your tube will be very damaged which might affect fertility in the future (but by no means would make you infertile)

Its so hard an ectopic not just the pain, treatment and what not but the loss of your baby. Its not all doom and gloom though and less than 6 months later I was pregnant again, healthily this time and am now 15+2 weeks and all is going well. So don't give up hope, having watchful management or methoxtrate doesn't damage your future pregnancy prospects in my experience.

Again sorry for your loss and good luck for the future, there is every chance you will be pregnant again healthily soon! xxx

landery welcome to MN, sorry it is under such sad circumstances. I had an ectopic pregnancy diagnosed in Dec 2008 after very much the same experiences as you. I wasn't given an option, but was rushed from my scan up to the ward and operated on the same day.
Sadly I lost a tube, we were both devastated. I was 38, took me year to get pregnant. Consultant (who was heavily pregnant) held my had a reassured me my chances of getting pregnant again were only reduced by 20% as the remaining tube would "float" between the two ovaries.
I went home, got very pissed as Christmas and did lots of crying.
Fast forward to Feb 2009 and I mentioned to a friend at work that I felt sick, she said she did too. Next day I asked if she still felt sick and she said no, we both looked at each other as the question popped in our heads.
She sent me off to the chemist and I did a test in the loo at work and it was positive. Called the doc and he sent me to the hospital for a blood test, 5 days later I got the call to say "Congratulations you are 8 weeks pregnant". It was 7 weeks since my ectopic.
My due date went from 17th July to 17th Sept. I was scanned straight away to check everything was "in the right place"
I now have a very beautiful Daughter who is 4 1/2. Sadly after her I had a miscarriage and as I was 42 we stopped trying, so she is my little miracle baby.

I haven't heard of the Meth injection so can't comment on that, I just want you to know loosing a tube is not the end of the world you can become pregnant with one tube and very quickly .

I'm sorry for your loss. I have have had three ectopics and was treated with meth for one of them. I would always go for this option first given the choice. It worked for me although it caused me to loose a large amount of weight. The only down side is you have to wait 3 months to try again but depending on how you recover from surgery the wait may be the same. It took me two to three weeks to recover from surgery each time but everyone's different.

I'm sorry for your loss. I have have had three ectopics and was treated with meth for one of them. I would always go for this option first given the choice. It worked for me although it caused me to loose a large amount of weight. The only down side is you have to wait 3 months to try again but depending on how you recover from surgery the wait may be the same. It took me two to three weeks to recover from surgery each time but everyone's different.

Sorry for your loss.

My first pregnancy was ectopic. Rushed straight to surgery. They tried keyhole (laparoscopy) but failed and ended up opening me up (laparotomy) and I lost a tube. Struggled to get pregnant again and told chances of natural pregnancy next to nil and referred for ivf. Worked first time and shocked to find naturally pregnant again when twins were one. It wasnt the route we expected but we got there in the end

I had an etopic operated on and left with one tube, thinking that that was it I would not get pregnant very quickly I was a tad irresponsible re contraception. four months later pregnant. so it does happen and fairly quickly if you are lucky

oh and sorry for your loss it really sucks losing a baby in this way Dont be afraid to grieve for your baby

Hi all, thanks so much for taking the time to respond. It's really uplifting to hear of successful pregnancies after EP.
Havetowearheels- your story is amazing! What a miracle- thank you for sharing.
I guess now I'm just waiting on my HCL level results from this morning. If over 5000 I think the docs will recommend surgery, but if under maybe I'll start with the meth. I'm just really aware of every twinge now- very scared of rupturing!

Good luck landrey. My friend had an ectopic pregnancy a year ago, she had surgery and lost a tube. She was understandably worried about her fertility, particularly as she was 35. But after waiting a few months she then started TTC and is now pregnant with everything in its correct place.

Yes I fell 8 days after the op (I had a laparoscopy, so just two little scars, one in my belly button), after a few drinks.
Take things easy and take some time to grieve, you may not feel the loss yet as you are too busy worrying about what could happen (only natural, it is a dangerous situation to be in).

I 'luckily' MC an ectopic in February last year so had neither surgery or Meth. Its a tough call. I think personally I would have surgery. over and done with in one go.
Why I'm really here is to let you know I soon got pg again and am due any day. It's really stressful, especially in the first few weeks, but it'll happen.
When the time comes to start again, look on the conception board for 'Posifrickentivity' thread. Its for people trying to conceive after mc. Its bloody brilliant.

I had a laparoscopy for an ectopic in 2007 - it was first pregnancy and hugely traumatic. But I've just had my third post-ectopic dc! The vast majority of women go on to successfully conceive after ectopic. Good luck getting through the next few weeks, I remember too well how awful it all felt.

Sorry you're going through this. I had ectopic 6 years ago, was back and forth to hospital as they couldn't decide what was going on or what to do with me. In the end they decided to keep me in to do exploratory surgery the next day. Lucky they did as tube ruptured that night and rushed into theatre. Have never seen so many medical professionals in one room! Wasn't really in any pain either really, just felt dizzy lying down . Surgery was keyhole and obv lost tube but recovered really fast.
Questioned doctor on affect on fertility and he told me that it didn't really make a difference and the egg would find the working tube!
Anyhow I continued to get pregnant very easily and have 2 post ectopic children, including one happy accident! I've always asked for early scans though to check everything on right place.
Best of luck.

I had an ectopic in May 2013, unfortunately I didn't get a choice as was taken in to A&E by ambulance, scanned in EPAU and it was found in my left tube (i was 6+5), it had ruptured, I had a laparoscopy and they found it had aborted within the tube but was stuck and I was bleeding in to my pelvis. It did mean my tube was saved as i didn't have much bleeding from the site or scarring. Consultant said I was just unlucky but obviously had higher risk in future. I was 34 at the time am now 35yrs old it was my 1st pregnancy. I fell pregnant in Sept 13 this was a MC in Oct, then I fell pregnant straight away and had a MC at 6 wks end on Nov. I am now 8+5 and it's in the right place & still in there. The ectopic has been the worst & most traumatic thing for me personally and the recovery from surgery wasn't good, but you have to make the choice that's right for you and your future health. Good luck and you have my best wishes

My HCG has gone up to 6000 so it looks like the decision has been taken out of my hands. I should be going in for the surgery tomorrow. Quite scared but thankful to hear of all these successful pregnancies post-ep! Thanks again all xx

Another successful pregnancy post-op here, I had my salpingectomy on November 12th, fell pregnant the first month we were cleared to try, and am now 6 weeks pregnant - actually inside my uterus this time! :)

Best of luck landrey. Physical healing time was quite quick with the laparoscopy, but was very sad afterwards. Take some time off work and rest. Let us know when you are home

Sorry, I see you have to have surgery now. Good luck and hope it goes well for you. Be kind to yourself in your recovery.

My first pg was ectopic, treated with methotrexate. Unfortunately the first dose was unsuccessful so I had to have it twice. It involved weeks of blood tests, bleeding and pain, and I did wish in hindsight I'd gone for surgery.

On a more positive note, I have gone on to have 2 DCs with no issues at all (conception took a while after the enforced wait post metho, but not outside the realms of normal). I was really well looked after in early pg, scanned and blood monitored in EPU both times.

Good luck with the op landrey and wishing you a speedy safe recovery

Hi anyone who had the methotrexate injection. Did they rescan you and check your tubes again before TTC???

@Mumof2littleredheads

Hi there - no they don't routinely do that. I found it bloody impossible to get a HSG scan done on my remaining tube after methotrexate failed and I ruptured the first time. It took about 5-6 months. Also took that long to be invited for a follow up with the surgeon/consultant to discuss what happened. You are very much left to your own devices and told to call when you next get a BFP and they'll scan you at 6 weeks

I had an ectopic in summer 2011. I’d been to the GP with constant brown bleeding. GP brushed it off. Over the next few days it developed into really bad burning deep inside my lower back. Decided to take myself to hospital and thank god I did. I was scanned and they found an ectopic, later estimated to be at least 8 weeks. Was told to think about the choice of surgery or Methotrexate while they checked my bloods. Decided to give methotrexate a go, but was then told my hcg levels were too high. As I was waiting for the surgeon on call to drive in, my tube ruptured. I was taken down to surgery and a nurse rushed in to say surgeon was here so they began prepping. Then 2 mins later another rushed in and said it wasn’t actually him, someone else. By that point I was balling my eyes out knowing I had internal bleeding and the anaesthetist just put me to sleep. Woke up later and was told I was lucky to be alive as the bleed had filled my abdomen. Was told I would quite possibly need ivf and would need to get a move on if I did want kids as my fertility would be impacted and start to decline at 35, compared to the average 40. I had DS1 in early 2013 aged 28, DS2 at 30 and now pregnant with DC3 at 36, all naturally with no intervention. So it is entirely possible! Took me a long time to deal with what I went through and it still brings back a lot of difficult memories but a happy ending after all the trauma. I didn’t believe a word of it when the dr told me at the follow up that the remaining tube can ‘catch’ the egg from the side without the tube, but apparently miracles happen and DS2 definitely came from the side with no tube as they could see the corpus lutetium on my early scan. No idea which side the other two came from though!

@neatfreak999
The OP Landrey had surgery in 2014... 😅
Very old post.