Ectopic pregnancy & methotrexate - Part 3

Discussion in 'Surviving Miscarriage' started by gutterflower, Feb 27, 2009.

  1. Confused-Hasya

    Confused-Hasya Active Member

    Lena, I am sorry to read about your ectopic.

    I have read people's experiences on here that it has taken them a little longer after shots to conceive because their cycles got messed up. Do you know if you are ovulating every cycle? What was the cause of your ectopic? If it is a blocked tube, have you found out which side it is on?

    Take heart. I have read success stories on here. Good luck!

  2. nessa26

    nessa26 New Member

    Lena, I am one of those sucess stories. My ectopic was my very first ever pregnancy. What a way to start off pregnant, huh? Made me never want to try again, for fear of another. But, I did try again. I did have very wacky cycles after my ectopic. The metho messed up my cycles badly, and I ultimately needed Clomid to conceive, for my body was not ovulating regularly. Now I have my beautiful (and very fussy at the moment) 1 year old baby girl! Don't give up!!

  3. Lena

    Lena New Member

    My ectopic was a blocked tube on my left side. They never saw a baby or anything but my hormone levels were not increasing like they should have. I have pretty regular periods every 28-30 days. They are "normal". They never gave me a cause for the ectopic. I do have pain on my left side quite often but I don't know if I'm just watching for it or if it's a sign of some sort. I am so glad I found somewhere to talk this out. My husband thanks you!

  4. SallyNY

    SallyNY New Member

    Today is my 12th day after methotrexate. The cramping and the bleeding has subsided a lot. I just see a few spots here and there now over the past few days.

    However, I do feel some light pain in my lower abdominal area and the left side (where the ectopic is). It's a mild pain and it's not like cramping. It's more like if you did a few sit-ups after not exercising for a while.

    Has anyone experienced this?

  5. Lena

    Lena New Member

    I did experience a dull ache after a few days. My doctor told me it was the pregnancy reabsorbing. I had bleeding and spotting for weeks after the metho. I had a increase of pain and bleeding about a month after the metho. It scared me enough to call the emergency on call. It is apparently normal but nobody told me so I'm passing it on.

  6. frankie

    frankie New Member

    Hi, I'm new here and so glad I found this site. Here is my situation: My doctor suspects ectopic pregnancy because of my beta test results. I took pregnancy test the day my period was due (we've been ttc for a while) and got faint positive. Went in for beta levels the next day 10/26 they were only 21. 10/28: beta was 16, and the same 2 days later. At that point, Dr told me I would miscarry. I started bleeding a few days later (like a heavier period, I also had lots of cramping and lower back pain even before bleeding started). I thought it was all over; my doctor wanted me to go in for a follow-up beta one week later. To my surprise, my beta had gone UP to 73. The doctor said this was highly abnormal and suspected ectopic and recommended methotrexate. I wanted to wait and see... Well, two days later my beta had gone down to 64, but two days later (today), beta had gone back up to 120... I am going in for ultrasound tomorrow even though the Dr thinks my levels are too low for it to show anything. She wants to treat it as ectopic and give me the methotrexate but I'm not sure... The drug seems to have a lot of side effects and screw up your cycle and we really want to ttc again ASAP because of my age (37). I of course don't want to risk my life but don't want unnecessary treatment either.. Has anyone else had such low beta levels, falling then rising and does this always mean ectopic? I don't have any pain or bleeding right now. Can this possibly resolve on its own? I would appreciate any advice.. this is my first pregnancy ever and we really wanted this baby.

  7. SallyNY

    SallyNY New Member


    If it's an ectopic, it won't be a viable pregnancy. Have you consulted with another doctor? There are Sonogram Imaging Centers with very high tech machines that only specialize in this. They might be able to conclude one way or another if it's an ectopic.

    If it's an ectopic, you would not want to wait to resolve it whether it be methothrexate or surgery b/c it can rupture and then cause a whole series of new problems.

    But I recommend that you go to an Imaging center. The machines at a regular obgyn office are not advance enough.

  8. labby06

    labby06 Active Member

    Frankie, your story sounds very similar to mine as far as the jumping numbers goes. In Oct of 2008 I got a very faint positive a week after my missed period. We had been TTC for about 4 months at this point. I called the doctor the next day and scheduled my first set of appointments. Later that day on the way home I started having some cramping. By the time I got home the cramping was getting severe and I was also bleeding - a LOT. I called the on call emergency number for the practice I was going to and the jerk of a doctor called back and told me that it was probably just my period or I was miscarrying and there was nothing they could do. He didn't really seem to care at all. By 10:00 that night I was screaming in pain and ready to tell my DH to take me to the hospital. He instead called the on call emergency number again seeking advice from the doctor asking if he should take me to the hospital. The same jerk doctor called back and told him that his "perception" of my pain was probably making it worse than it really was and that I should just take some advil and go for a blood test in the morning. We could go to the hospital, but they wouldn't do anything except charge us a lot (his words). So we heeded his advice, and the next day went for the blood test. That number came back at 52, super low for the 5 weeks I would have been. They had me go for another HCG a few days later and my numbers were cut in half. They diagnosed it as a miscarriage and had me go for weekly HCG's until they got to 0. The following week my numbers had dropped (can't remember exactly what they were but in the teens I think). I went again the following week but never got a call back with the results, so I ended up calling the office. When the nurse called me back the first thing she said was "how are you feeling" which I thought was a bit odd, but I was ok, just sick of the bleeding that had been going on for 3 weeks at this point but didn't really have anymore pain. She told me my numbers had jumped back up to 74 (or something like that) and that I needed to come into the office right away because something was wrong and I could be in danger, but doesn't tell me anything else. I called DH hysterical and had him meet me at the dr's office. Usually when you go to the doctor you end up sitting in the waiting room forever, but not this time. As soon as I got there they rushed me back which scared me even more. They did an ultrasound and there it was....stuck in my right tube. I ended up having to see the jerk of a doctor that was on call that fateful night (after sitting in the waiting room surrounded by pregnant women while crying hysterically). I will never forget this, he came in and said to me "oh, so I guess it wasn't your period after all." I seriously thought DH was going to tackle him. Anyway, he said I had 2 options, metho or surgery, but he wouldln't recommend the surgery because it was a Friday afternoon. We opted for the metho, but before I could get it I had to go to the hospital lab to have my liver function tested. To this day that was the worst day of my life. Needless to say, I swore I would never see that doctor again - and never have. He certainly didn't help matters.

    So after the first shot I went for another HCG and my number only dropped by one point. ONE STINKING POINT! And they weren't that high to begin with! So I ended up seeing a different doctor who recommended another shot of the metho which I wasn't happy about but whatever had to be done to end this misery. After the second shot I finally went down to 0 within a week and finally got to see my normal doctor for the first time throughout this experience.

    There are varying opinions on the proper time to wait after metho. The first doctor (the jerk) told me 3 months for each shot, so since I had 2 that was 6 months. The second doctor said no, just 3 months. The last doctor (my regular one who I really like) said that there is no research to prove that there is any benefit to waiting. According to him, most doctors say to wait because it is the "safe" thing to say, no harm in waiting, right? But he is a hard evidence type of guy, and without seeing any research proving the effectiveness of waiting he said it was more up to us and when we were ready emotionally, and of course when my body was ready. He suggested waiting for at least 1 normal cycle just to make sure things were back in order, which we did.

    The metho really screwed up my cycles. I waited that one cycle which occurred about 3 weeks after my second metho shot. I was so excited about trying again. I then went 62 days without a period. Yes, SIXTY TWO! I kept calling and begging them to give me something to jumpstart my cycles, but they kept telling me to wait it out. I was charting my BBT at this point trying to track my ovulation. After finally getting my period after 62 days of waiting I thought I was back on track. In addition to charting I started doing daily ovulation pee tests so I would be sure to catch my next ovulation. I didn't ovulate until CD24 during that cycle, but I did ovulate and we successfully conceived that cycle. I got a positive HCG on 2/16/09 (about 4 months after the ectopic) and started the HCG tests right away. This time they skyrocketed every 48 hours which was wonderful, but that was the longest 2 weeks of my life waiting to see my little bean. I now have a happy and healthy 1 year old little girl, so there is hope!

    If they do believe it is ectopic you are better to have it treated right away rather than playing the waiting game. If it is stuck in one of your tubes, it could rupture causing internal bleeding which is a huge risk to you, and you could end up losing your tube for good which would really hinder your chances of conceiving, although it is still possible with one tube. The metho does have side effects, I won't lie. I likened it to having the flu, just without the sore throat and congestion. I was very achy and tired and just felt very run down with both shots I had. It did mess with my cycle, but it also gave me the opportunity to learn more about my cycles and how charting my temps could help me figure out when the best time was to TTC which ultimately led to our wonderful little girl.

    I had no risk factors for ectopic, so to this day we do not know what caused it. I do suspect I may have endometriosis, and the ectopic kind of solidified that suspicion for me since it is a risk factor, however I haven't been officially diagnosed with it since it requires laproscopic surgery to get a true diagnosis. So maybe my risk was higher, I'm not really sure.

    I'm so sorry you have to go through this. It was seriously the worst experience of my life. But being here and reading everyone else's stories of success after ectopic is what gave me hope, so I hope my story can give you hope as well.

    And sorry for the super long post. It's been a while since I've posted over here so I wanted to include the details of my experience so the newcomers would know what I'm talking about! [​IMG]

  9. SallyNY

    SallyNY New Member

    Thanks for the posts. I check back here everyday. It's been nearly two weeks since my shot and over the last 2-3 days, I've been feeling a mild to medium pain along my lower abdomen and the left pelvic side. It hurts a bit when I cough or sneeze or if i press down on the area. I'm scheduled for my 14-day HCG test tomorrow at the hospital. At this point, I haven't had any sonograms to see if the pregnancy decreases in size. But I'm thinking I should do this tomorrow with the pain I've been feeling.

  10. nessa26

    nessa26 New Member

    Frankie, I understand your hesitation and concerns. Labby's situation sounds very familiar to yours. Hopefully with even low numbers, they can come to some kind of conclusion as to whether its a miscarriage or ectopic. Its not a viable pregnancy, and if the levels don't come down on their own, metho may be the best decision. I know that's not what you want to hear, but its safer to do that, than to allow the pregnancy to continue growing and risk rupture.

    I had one shot of metho that was decreasing my betas, but also causing the blood from the dissolving pregnancy to come out my fallopian tube and into my abdomen. A trip to the ER and then an exploratory surgery later, and my affected fallopian tube was removed. Devastating to me, yes, but it also saved me the risk of getting another ectopic in the same tube. You only need one tube to conceive, and I did. My daughter is 1 year old. Let us know what the ultrsound reveals.

  11. Lena

    Lena New Member

    Frankie I'm sorry you have to go through this on your first pregnancy!. I had an ectopic that was never found either. I had two internal ultra sounds done because I didn't want to believe I had an ectopic. My hormone levels were not increasing as they should have and the doctors said the pregnancy would not be viable. I could wait to see what would happen but that would increase my chances of having more complications. I was able to have the metho and not have surgery because it was caught soon enough. My cycles are very regular now after the metho but I have not conceived again either. For me, I needed to be sure I was doing the right thing for me and the doctors could say what they wanted but I had to be sure. Two ultrasounds and my minimal hormone increase convinced me. Do whatever makes you feel comfortable.

  12. frankie

    frankie New Member

    Thank you ladies for all your support and feedback. So much has happened since I wrote the post: Around 1:30 yesterday, I went in for the ultrasound and my ob/gyn saw blood in my abdomen.. She was concerned, said methotrexate was not an option now, and I probably needed surgery THAT DAY. I was shocked and so scared. She kept asking me if I had pain but I didn't. So she sent me over to another medical office connected to the hospital to get a better ultrasound at radiology. Thankfully my husband had come with me to the first appointment and was with me all day. At radiology, they spent what seemed like forever looking at the screen, trying to find something. In the end, they too saw blood in my abdomen but could not see where the pregnancy was (both ultrasounds showed nothing in my uterus). I spoke with my ob/gyn on the phone and she told me I should see the ob/gyn on call at the ER and she thought the other doctor would also recommend surgery. We went over the ER and the ob/gyn there also recommended diagnostic laparoscopy. They were concerned about the internal bleeding, and told me all the possibilities of the surgery. I really felt like there was no choice because they thought if I didn't there might be the possibility of a more serious surgery needed and a more critical situation. They also suggested a D&C to diagnose if pregnancy was definitely not in the uterus, but I refused. I knew that there was no way I had a viable pregnancy either way, but just did not want another procedure that was not absolutely necessary...And my ob/gyn basically said "it IS an ectopic" and I trusted her opinion. I also spoke with the surgeon extensively and asked him if he would look to see if there was endometriosis or anything else that could have caused my difficulties getting pregnant, and he did look for that too. So, I had the laparoscopy. When I woke up, the Dr told me that it went very well and both my tubes looked healthy. He took out what he thought was pregnancy tissue coming out of the end of my right tubes. He said it looked like it might have been aborting on its own which might be the source of the bleeding, or the bleeding could have been retrograde menstrual blood. He said bleeding was not continuing when he got in there and was not that bad. He still thought that he might not have gotten all of the pregnancy. Since I was so early, it was very, very tiny and he thought there might be more in the tube, but he didn't want to cut into my tube unnecessarily since I was a good candidate for the methotrexate. After learning that my beta in one day had risen again (to 154 from 120 on Monday), I decided to get the shot rather than risk the pregnancy still growing.

    I feel very lucky; I know it could have been much worse. I was also relieved that he said everything looked healthy. There was a tiny piece of endometriosis that he removed, and he saw a tiny fibroid, but both he said were so tiny they would not affect fertility. He also said that whether I took the shot or not, I should wait at least a couple cycles before ttc again, and that the methotrexate would not delay it further and actually might help my body get back to normal sooner. I'm hoping that's the case although I know some ladies have had troubles with their cycles afterwards... I was able to go home last night around midnight and am just trying to recover... My abdomen is pretty painful where the incision is and I'm bloated, but I don't think I'm feeling any effects of the methotrexate yet... But it seems that it may take a few days to kick in? Or maybe I won't have bad effects? I just hope the betas go down after this. I go in Friday, and then Tuesdays for more betas.. Thank you again, ladies. I didn't get a chance to read your replies until today, but they reassure me that I made the right choice. It is also so wonderful to hear that some of you ladies have had successful pregnancies after an ectopic. I know my chances are a bit lower now because of this and my age, but I have hope.

  13. SallyNY

    SallyNY New Member


    Over the past few days my lower abdomen and left pelvic area where the tubal pregnancy is has continued. It's mild but it does hurt when I bend over, sneeze or cough. I also feel extremely bloated on most days. I last mentioned that the bleeding has come down significantly. Two days ago, it started getting heavier again. I was thinking that everything was getting better but then the pains and bleeding came back again.

    Here are my Beta HCG numbers so far:
    Just prior to shot: 1742
    4 days after shot: 1449
    8 days after shot: 900
    14 days after shot: 620

    It seems to be going down fine, but at this rate, I still have weaks of testing and wondering ahead of me.

  14. BJ99

    BJ99 New Member

    Hang in there numbers were in the 7,000 prior to the first shot and then 11,000 prior to the second shot and they decreased after that by 70-80% every week but it still took 7 total weeks for them to go down completely less then 5 is considered 'Not pregnant'.

    It sucks but the pain will be off and on and certain things will set it off that you don't expect.

    You're more then half way there so just try to relax.

    ~Jen [​IMG]

  15. SallyNY

    SallyNY New Member

    21 days after shot: 19

    The numbers came down a lot from last week at 620. The bleeding stopped two days ago but I still feel some mild pain as described in earlier post. I need to continue with the blood work until the beta HCG reaches less than 5.

    The blog has been a tremendous source for information and support. I will try to come back from time to time and document any new developments in case it helps with anyone else' situation.

  16. Confused-Hasya

    Confused-Hasya Active Member

    Good to hear, Sally. I hope you're well on your road to recovery soon.

  17. RN GU3

    RN GU3 New Member

    Hi, My name is Amanda, i'm new to the site although I have read through the posts a bit to see what others have been going through. I was diagnosed with an EP on Oct 31st, my levels were 2800. This was my first pregnancy and I had been feeling fine but I started spotting on the 30th which is what brought me into Emerg. On the 31st I had a transvaginal ultrasound where the ectopic was seen. I chose to have the MTX injection as the OB said i was the perfect candidate, low levels, no heartbeat. I was relieved as I have an intense fear of surgery. On day four my levels were 7700. By day 7 they had dropped to 5200. I was then told to follow up weekly with my levels. They have continued to go down nicely and on Tuesday were down to 350. On Monday however, I was experiencing terrible abdominal pain, and horrible pain in my back and shoulders when i layed down. I went in to see my OB who examined my abdomen and said he believed the EP may be leaking a bit out the end of the tube as it is breaking up, to go to ER the following morning for another ultrasound but if pain got worse to go in immediately. I felt much better after speaking to him, I went home, relaxed (tried to) and got ready for the following day. Tuesday I was feeling much better, no more pain in back or shoulders, only slight discomfort to abdomen when i pressed on it. Went in for ultrasound where it showed the EP was still there but I had a ruptured cyst on my right ovary. I also had fluid in my abdomen which could be from the ruptured cyst. Did levels that day and were 350, down 220 from five days prior. OB believes the fluid was from the cyst but also from EP leaking a bit, but since I was feeling better I could just continue to monitor my levels down to zero but if i started feeling worse to come back in again. I was finally feeling good again, have been bleeding pretty much since Oct 30th, but had come to terms with what happened and was ready to try again in the spring. I am now feeling scared all over again, afraid to be alone, having my mom sleep here as my husband works steady nights. I knew i still had a chance of rupture but thought since my levels were coming down nicely my chances were low. I'm so frustrated and I think i've decided I don't ever want to try again, I will look into other options. I'm still feeling ok physically, still slight discomfort in abdomen, some twinges of pain on right side (Where EP is) but nothing severe. Sorry for such a long post, just needed to vent I guess.....

  18. BJ99

    BJ99 New Member

    I only have a few

    But welcome Amanda and I'm sorry for your loss.

    I do however know your hesitation as I remember feeling similar right after mine. But those baby of your own vibes come back after you stop crying everytime you see someone else with a baby. In my case my other half made me hold a baby and although I cried a reinforced me wanting to try again.

    Your numbers are coming down nicely but do make sure when they do ultrasounds that they are monitoring the fluid/blood as well and make sure that disapates as it can still cause you to have to have surgery if it doesn't as it has to some here.

    For now just focus on staying away from folic acid till your numbers hit zero then go back on your preg vits just in case and play it by ear for anything else.

    Hang in there hun...we are hear for you!



  19. 2times

    2times New Member

    I'm so happy to have found this forum. Many of the post are old, but were very helpful. I had an etopic pregnancy in August of 2009 and now I'm again suffering from an etopic pregnancy again. The first time I was ok with it, because I understand things happen, but this time I'm not taking it so very well. I already have a beautiful 9 year old daughter, but I'm engaged to be married and I feel like I will never be able to give my fiance what he is dying for. Although the last two pregnancies we did not try because we are waiting for marriage. However, when it happens we get excited about it. Then our excitement is crusehed by it being an EP. I'm really feeling less than a woman right now. I must admit I had an abortion once after my daughter because I was ending a very bad relationship and I had no problems in conceiving a normal pregnancy. Now I'm with this amazing man and two times now it has been in my tubes. I wonder if I should have the surgery and get that bad tube removed on my left. I got extremely sick last year and I'm afraid of becoming violently ill this time as well. I wound up in the hospital 2 days after my shot last time. So here it is now 3 days later and I still feel pregnant and no bleeding in sight. I'm sooooooooo confused. Last time I didn't even appear pregnant, however this time I look it...I have a buldge and it makes me sooooooo sad, to know the baby won't make it.

  20. BJ99

    BJ99 New Member


    Sorry you have had a repeat...honestly I sorta know the feeling. Many of us after having the EP have then suffered chemical pg's/miscarriages.

    Have you had an HSG? If only one of your tubes are blocked then they can monitor you thru your cycle give you clomid (which makes you produce multiple eggs on each size and then they can tell which side your ovulating on (even without the clomid) and you only TTC on the months in which you ovulate from your good side. I def wouldn't let them go in and remove it if unessesary. And it's possible to work around the blocked tube plenty of ladies here have done it.

    It took 2 shots for me before I officially lost the baby (started bleeding) and my numbers started to go down, hang in there. What are your numbers? How many weeks were you?




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