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Fluctuating Hcg level after methoxtrate shot

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Joined: Wed Jun 03, 2020 4:52 am

Fluctuating Hcg level after methoxtrate shot

Post by Sneha3012 »


I was diagnosed with ectopic pregnancy and had given 2 shots of methoxtrate on 6th May and 13th May after which my levels dropped. My levels before injection was 400 and it dropped to 360 after 1st shot however again increased and that Is when I was advised to take second dose. And after the second dose it declined to 195. And then it declined to 139. However, my last blood report was at 145. Can someone plz advise if it isnormal or something to be worried about. If at all someone has experienced the same please let me know.


EPT Host 22
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Joined: Fri Nov 20, 2015 10:26 am

Re: Fluctuating Hcg level after methoxtrate shot

Post by EPT Host 22 »

Hi Sneha3012,

I am so sorry to hear you are suffering an ectopic pregnancy and loss, and going through this worrying time. I'm not medically qualified to comment on your specific situation and I will do my best to help.

As you've already experienced, the second shot of MTX will be given if hCG levels do not fall as doctors would like. In general, the hCG level often rises on the day four blood test because the action of Methotrexate is not instantaneous, so the cells will have continued to divide for two or three days after the injection was given, and some cells release more hCG when they start to disappear. Your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven. If there has not been a 15% drop, this is when the doctors will consider a second dose of Methotrexate or surgery.

Every 3-7 days, beta hCG levels will continue to be monitored to ensure that they are falling appropriately. Most women only need one injection but in up to a quarter of cases a further injection may be required if serum hCG levels are not decreasing.

It's very important that you continue to be monitored through blood tests, and I'd strongly encourage you to continue reaching out to your doctors with any concerns. Certainly, if there is an increase in bleeding or pain, especially shoulder tip pain, it will be important to seek medical attention through your A&E.

I know what an anxious time this can be, and want you to know that we are here for you throughout.

With good wishes,


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