Ectopic pregnancy advice please

[Roxannee]

Hi everyone, I'm new to the group, and joined to get other people's feed back.

So today I had confirmation that my pregnancy is ectopic.

I'm 6 weeks, I am taking pain killers for the pain, and have been spotting on and of for 1 and half weeks.

My hormones levels have dropped with in 48h, and because of this they want to just monitor me (via bloods every 48h) rather than give me injection, in hope my body will reject the pregnancy on its own.
and been told if in excruciating pain to admitt myself to hospital, as more than likely my tube would have ruptured.

The question is...... Has any one exsperianced this?
How far will they let me progress before they terminate it. (I'm worried my tube may rupture)
I just want others input and storeys as no one I know has exsperianced an ectopic pregnancy.

Thank you, and sorry for the long post.

Sorry you are going through this.

Hopefully the doctors have talked you through the options for treatment of ectopic pregnancy, and explained why they have recommended waiting and watching (expectant management)? The other two options are either surgery, or a medication called methotrexate. Both of those can be effective but have some side effects, and some ectopic pregnancies are more suitable for certain types of treatment.

If your HCG level is falling by itself that usually means the ectopic has stopped growing of its own accord, therefore neither of the other treatments are necessary. The best option in your case is to carefully wait and see - most likely this way you can avoid any risks that come with the other treatments, keep both your tubes, and be able to try again hopefully sooner.

As they’ve told you, it is still possible for an ectopic to rupture when the HCG is falling, so you do need to make sure you pay attention to your symptoms, and get the follow up hcg tests they will recommend. Also - make sure you use contraception until the hcg is back to 0.

Hope that helps.

I've had an ectopic yes and like you I was told it was fine because my hcg was coming down. I still insisted on the methotrexate injection though and I'm glad I did. Methotrexate is a bloody awful drug and you'll feel sick as a dog but you'll be safe and keep both your tubes. I was nearly 8 weeks when they finally admitted it was ectopic (after I had been bleeding for 2 weeks and they'd sent me home from hospital 5 times). As you can imagine this gave me no confidence in my 'care team' whatsoever hence me insisting on the methotrexate.

Sorry you're going through this. I had an ectopic pregnancy although it was a slightly different situation in that it was a pregnancy of unknown location right up until it ruptured. The early pregnancy unit could not locate it on repeated scans over the course of 2 weeks and my hcg kept increasing slowly but not doubling. They didn't want to use methotrexate unless essential because of the associated risks and they felt it was likely to resolve itself without intervention. Unfortunately it ruptured when I was around 7.5 weeks I think (it was 2 years ago and can't remember exactly). It still wasn't visible on the scan at that stage, so they were still watching and waiting, although with hindsight the reason it wasn't visible was because it was right up by the ovary. I was lucky in that it started to rupture while I was at the hospital in the scan room so was taken straight to emergency (in resus for a while, which was scary) and then surgery.

I would follow the advice of the doctors but ask a lot of questions. Methotrexate can help avoid rupture or surgery in some ectopic pregnancies but isn't always suitable and expectant management may be better for your situation. If you want to conceive again quickly it's better to avoid methotrexate if possible (although I imagine it is preferable to surgery!!) so expectant management may make most sense.

I had this exact thing in Feb I was left another week but my hormones didn't come down enough they weren't high though they were only 180hcg but I wish I had just asked for the methotrexate sooner as you can't try for 3months after the injection and it takes a few days for them to get the injection made up etc however I was fine off the injection and once we started trying i got pregnant the 2nd month we tried after that and am now 40 weeks pregnant so there is hope, it took me 6 months to fall pregnant with the ectopic but only 1 after it xx

Thank you everyone for your feedback. And for making me feel better with the thought that there is still hope. Been trying for 1.5 years and this is 1st time anything has stuck.

Will speak to hospital again today, ask all the right questions, like one of you stated don't want to wait possible a few weeks then have to take the Injection, and potentially just have waisted 3 weeks for no reason if you know what I mean.

Thanks again ladies.

I had an ectopic in July 2019 - I was spotting/bleeding off and on continually and back and forth to EPU. They traced my bloods over 48 hour intervals, initially still doubling but nothing visible on a scan which they put down to being too early. I continued with the blood tests and my hormones started to drop but very slowly. They weren't happy at the rate they were falling, it indicated that whilst I was bleeding, including clots, I hadn't managed to lose all of the tissue & was unlikely too. I was advised methotrexate by injection as I was needing some form of medical management - I was kept in EPU for a few hours as they had it made up and administered and then allowed home.

EPU were great with me. Methotrexate is a strong drug, it can make you feel unwell, and the 3 months afterwards where we couldnt TTC, were the longest ever.

One thing I do know though is if I ever had to go throw an ectopic again, and methotrexate was a choice over surgery, I'd take it.

Good luck OP. If you have any questions, please send me a message, happy to try and answer as best as I can x

@Roxannee My ectopic was also my first pregnancy. I've since gone on to have 2 children and am pregnant with my third now. All natural with no problems. Keeping both tubes helps of course which is why I think you should push for methotrexate but I just wanted to let you know it's not the end of your journey to parenthood. A friend of mine also had an ectopic and did lose her tube for her first pregnancy. It took her longer to concieve than me but she also has 2 children now.

I also had an ectopic in Feb this year which was resolved using the watching and waiting. My HcG levels were only around the low 200s when it was discovered and they were slowly dropping. I was also bleeding. After a few 48 hour blood tests they decided to move to weekly tests as they were still dropping. There was one scary day where I was told to be prepared to be taken for surgery that afternoon but in the end they decided to wait. I think I bled for nearly 2 weeks in the end, but never particularly heavy, I felt it was lighter than my periods and a lot more watery.

Personally I was happier to wait and didn't demand the methotrexate as it's a horrible drug (chemotherapy) and if I'd have had it I wouldn't have been able to TTC for another 3 months. I was lucky and managed to get pregnant again the next month.

If I was you I wouldn't push for the injection, but maybe ask them what your HcG levels were to start with and what they are now so you can see how quickly (or slowly) they're dropping. The fact you're bleeding suggests that your body is trying to miscarry naturally which is the best possible outcome really even though it's a frankly crap situation to be in :(

Sorry you are going through this.

I've had 2, one in each Fallopian tube.

I had one tube removed the first time as mtx wasn't available in my hospital then, and then the second time 3 years after the first I was treated with methotrexate.

I did have second tube removed eventually as it was badly damaged with hydrosalpinx.

(Child born via ivf after both tubes removed so not all doom and gloom)

Take care x

Hi @Fredthespider I was discharged on the 9th December with HCG level 9. I havent been to the doctors since, did you get checked over before TTC again, or just go for it? I cant work out what to do?
Thanks in advance for coming back!

@Crownchakra

Hi *@Fredthespider* I was discharged on the 9th December with HCG level 9. I havent been to the doctors since, did you get checked over before TTC again, or just go for it? I cant work out what to do? Thanks in advance for coming back!

@Crownchakra sorry to hear you’ve gone through the same. We didn’t wait or see anyone for a check up we just went for it. I ovulated 19 days after the spotting for the ectopic started, but it was only about a week after I got the all clear from the hospital that my bloods had dropped below 5. My rainbow baby was born in Nov just gone and I’ve got my fingers crossed you catch again soon!

Thanks so much @Fredthespider for coming back! Really helpful and congratulations