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First shot of methotrexate didn’t seem to work

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lenia
Posts: 2
Joined: Tue Apr 19, 2022 9:50 pm

First shot of methotrexate didn’t seem to work

Post by lenia »

Hi,

Following a missed miscarriage last November I fell pregnant again in March. However, after a series of symptoms, abnormal HCG levels and inconclusive ultrasounds, the doctor diagnosed PUL. My HCG levels are pretty low so they decided to give me the methotrexate shot. The day of the injection my HCG was 189. On day 4 it was 227 and day on 7 it was 212. So obviously not the at least 15% drop. They suggested to wait two days and repeat a blood test and take it from there. I would like to ask:
1. Does anyone has an experience of slow drop on day 7 and then it went ok without having to take a second shot? I am afraid of side effects.
2. I am about 8 weeks pregnant. I know that my HCG is pretty low, but is there a high risk of rupture as days pass?
3. I have no children and the whole experience of the MMC and the ectopic these few last months makes me feel like this is not meant to happen for me. Has anyone any positive stories to share?

Sorry for the long post.

EPT Host 20
Posts: 3155
Joined: Thu May 31, 2012 10:58 pm

Re: First shot of methotrexate didn’t seem to work

Post by EPT Host 20 »

Dear Lenia,
I am so sorry to hear of your ectopic pregnancy and loss,
It is difficult to give you precise advice about methotrexate as the way it works (how quickly our hCG levels drop) depends upon our unique physiology and how high the levels were. I understand it is daunting to think of a second injection and I appreciate how long and drawn out it can seem, but it isn’t as invasive as surgery and I am sending positive thoughts that your levels continue to drop. Sadly there is a risk of rupture with low and decreasing levels, so do not do any heavy lifting or strenuous housework and avoid medication such as ibuprofen which interacts with the methotrexate.

I know thinking about conceiving again can be daunting, but there is a 90% chance of the embryo being in the right place next time. We also advise getting an early pregnancy scan at around 6 weeks with any subsequent pregnancies. It is often reassuring to know that we are under the watchful eyes of medical professionals early.
Personally, my first pregnancy was ectopic, treated with methotrexate and I went on to have 2 healthy pregnancies following this, so I hope this gives you some reassurance. We also have a Preparing for your Next Pregnancy board for you to look at whenever you feel ready.

For now, be kind to yourself and allow time to grieve and heal both physically and emotionally.
We will be here for as long as you need.
Sending much love,
Karen x

lenia
Posts: 2
Joined: Tue Apr 19, 2022 9:50 pm

Re: First shot of methotrexate didn’t seem to work

Post by lenia »

Hi Karen,

Thank you for the reply. I just wanted to say that I had my blood test repeated today (Day 9 after 1st MTX shot) and HCG finally dropped. It went from 212 to 132 in 48hours so hopefully things are moving to the right direction. I know that I am not yet out of the woods but I just wanted to update in case someone is looking for some answers in future.

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