2x PUL pregnancies and methotrexate

[ScouseMouse888]

I'm pretty numb right now. I have no living children and five miscarriages. Last July I had a PUL (pregnancy unknown location) and after five weeks, as the HCG would go up and down, I ended up having methotrexate. This was fine overall but of course, we couldn't start TTC for three months.

Fast forward to this month and I find out I'm pregnant again after TTC in November. It's Groundhog Day. I can barely believe it. PUL. The HCG is going up very very slowly and they're keen to give me methotrexate again and not wait so it looks like that's what I'm having tomorrow.

"Heartbroken" doesn't even cut it. Has anyone had this happen and actually had a successful pregnancy after it? Have you got any advice? No one seems to be able to answer why this has happened or how it can be prevented?

I don't get pregnant quickly, I'm 39 and devastated.

Lost for words.

So sorry this has happened to you. Have you already had any investigations? Suggest asking your GP for a fast-tracked fertility referral if not. Maybe a HyCoSy, where they flush your tubes, could make a difference or perhaps they'd suggest IVF so that your fallopian tubes are bypassed entirely.

Thank you @sirensong. They have investigated the miscarriages and came to the conclusion it's hormonal (I've always suspected an issue with progesterone) so this was the first pregnancy with progesterone.

I just can't believe I am here again, going to hospital this morning 😔

You poor thing OP- PUL is an awful experience to go through once, let alone twice. I had a PUL and then a successful pregnancy shortly afterwards if you want a hopeful story. But I didn't have methotrexate- they just did a d&c and found the pregnancy remains that way (it was in my uterus, just hadnt developed enough to show on scans - hcg kept rising and i didnt miscarry on my own). Could you push back on the methotrexate option if they're not sure the pregnancy is ectopic? More specialist scans to try to locate it?
Edited to add- not trying to suggest that there's anything wrong with methotrexate as a treatment option, it just sounds so demoralising for you to have another 3 month wait to ttc again

Thank you @Newnamesameoldlurker - I appreciate your story. Last time I had weeks and weeks of waiting, the fairly low numbers would faff going up a few, down a few... etc. This time it's doing similar but the numbers are like 300 at the moment.

I'm hoping both were like yours, in the right spot but not miscarrying as they're "meant" to. Did you bleed at all when the numbers were going up and down? I'm getting light spotting etc but the threat of ectopic scares the life out of me!

So sorry to hear this OP. All I can say is I was you a year ago - 2 miscarriages and 2 ectopic pregnancies, one treated with surgery and one with methotrexate. I made the decision to move to IVF with full medical intervention (progesterone, steroids etc) and am now 37 weeks pregnant. IVF isn’t for everyone but I personally found it far less draining than trying for years on end with nothing to show for it. I hope all goes OK resolving this loss xx