HCG levels INCREASED after 4 weeks dropping post MTX

[Elephant+1]

Hello,
I had my MTX injection 29th Nov, it rose on day 4 (which I now understand can be normal) and has since dropped by 50% or more on a week by week basis. Today I was booked in for my day 35 post injection, which is 5 days after my last bloods instead of 7, and my HCG has gone from 124 on Thursday to 136 today.

What does this mean? Why has it increased 10% so late on?

I’m feeling sooooo disheartened and upset as I just want this over with and I felt sure I’d be seeing double digits today

Thank you so much!

[EPT Host 20]

Dear Elephant,
I am so sorry to hear of the worrying time you are going through, it can be extremely difficult not knowing what is going on with our bodies.
Small rises can sometimes be a blip and they may reduce at your next blood test. Rising hCG levels can sadly mean that the methotrexate isn't working and this can sometimes mean that we need a second injection. Most women only need single-dose methotrexate injection but in up to a quarter of cases a further injection may be required if serum hCG levels are not decreasing.
I presume you have a follow up appointment for further bloods or a scan?
Whilst I do not wish to alarm you, I do have to remind you to seek urgent medical advice with any worsening bleeding or abdominal pain or you feel dizzy and unwell.
I hope you will get more answers soon.
Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
**************************************************************************
If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?
Further information is available at ectopic.org.uk
Email us: ept@ectopic.org.uk
We provide a call-back helpline service: 020 7733 2653
Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
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[Elephant+1]

Hi Karen

Thanks for your reply, I now have severe abdominal pain currently waiting in A&E

[Emmapx]

Hi elephants, came to check in and seen your post! I hope your okay please update on how you get on xx

[Elephant+1]

Hey,
Just got back from the hospital now.
So they suspected rupture as the HCG increased along with blinding pain and new bleeding. They did a covid test to admit me to a ward for the night then I was first priority for a scan in the morning but turns out, I had COVID for the first time EVER! Literally the worst time to get it too! Because it meant none of their wards would take me but they wouldn’t let me go home because they needed to monitor me, at 2am they put me in a trolley in an office and I had to move from first priority to last priority because of covid.

I’ve just had my scan now and fortunately the ectopic pregnancy has not changed, sat in my left tube, the same size, not tender, not ruptured, just minding its own business.

The pain is coming from the ovary as I now have a 5cm by 5cm cyst on it that is haemorrhaging inside itself. Honestly SO RELIEVED I cried the cysts are not uncommon and they’re not life threatening, doctor said it would only be a problem if it ruptured and started haemorrhaging into my abdomen so I now have 2 masses in the left side that I’m trying not to rupture.

My HCG levels came back down to the level they were last week in 24 hours so they think it was a blip.

The bleeding was not related to the cyst, the bleeding was related to the ectopic and I am not having a cycle where I have 10 days of no bleeding 5 day bleed and then repeat. The pain was nothing to do with the ectopic and the HCG levels just seem random. So it was just a very weird coincidence that on the day my bloods increase, I get excruciating pain AND start bleeding
AND HAVE COVID

I’ve only been at my job since June and the past 2 months I’ve not been able to work much. I’m worried my boss will start to think I’m making this up because even writing it, it feels RIDICULOUS!!!

They sent me home as I’m stable and they don’t want a covid patient on the ward but im still in quite a bit of pain from the cyst. Currently wrapped in my electric blanket, self-medicating with Christmas chocolate! Xxx

[EPT Host 20]

Dear Elephant,
Gosh you have been through it. I'm so sorry to hear you have covid too.
I am glad there is no evidence of rupture and your levels are decreasing again, I shall keep everything crossed they continue to do so.
I know you have covid, but it is important that you do not let that put you off seeking any further medical help should you need it. Either from the ectopic pregnancy or the cyst.
I Like the sound of your electric blanket and chocolates. Just don't out the chocolate on the blanket or it could get messy!

I hope things start to calm down for you,
Sending much love and warm hugs,
Karen x


The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
**************************************************************************
If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?
Further information is available at ectopic.org.uk
Email us: ept@ectopic.org.uk
We provide a call-back helpline service: 020 7733 2653
Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
***************************************************************************

[Emmapx]

Oh my god what an ordeal you’ve been through !! I hope your pain has relieved and you’re feeling better and your covid symptoms don’t get bad ! But yes as Karen said definitely don’t let covid stop you from being seen if you need to! Exact same as me a cyst on the left ovary that’s still causing me some pain, it must be common to get a cyst along with/after ectopic ! I hope your feeling a lot better soon sending love and hugs xxx

[Elephant+1]

Thanks Karen & Emma!
Definitely will go in if I need to, but I REAAAALLLY hope that’s the last of the A&E visits!!
I said to the doctor I’ve have my ovaries for 30 years how can I be this unlucky to get this cyst now?? And he said I’ve never had the cysts like this as I’ve never been pregnant before and they’re common with pregnancies!
The lady scanning me says some people get small cysts every time they ovulate and never notice…
No idea but isn’t being female just so much fun!!?

[piggycz]

Hi Elephant,

I came across this forum as I was googling ectopic pregnancy and mtx. I just to want to say that you are not alone, I just learned yesterday through an ultrasound that I have an ectopic and they gave me mtx same day. During the ultrasound they also found a hemorrhagic cyst above my right ovary (it was a right tubal pregnancy). Maybe there is correlation there. Stay strong. Thank goodness there was no rupture and caug hh in time.

[Elephant+1]

Hi Piggy,

I’m so sorry for your loss, it’s a tough time. Always here if you need to chat, MTX has been a ride for me so I hope you’re ok!
Oh must be a correlation then! It’s mad that it hadn’t come up in all my googling and then you get a cyst and find out a few people have them!!
So annoying because it’s still causing pain, am I just supposed to deal with it? When will it end?!
Xx

[Elephant+1]

My latest bloods have come in at 118, only gone down 2 points since 10pm on Tuesday why won’t this end for me?!?

[piggycz]

Thanks Elephant!
Definitely a rollercoaster this is kind of my 5th loss. Its devastating to be honest!

I’m also here if you need to chat.
I hope your pain goes away soon, how many doses did they give you? I’m also curious as to where you were injected if you don’t mind me asking.

[Elephant+1]

Oh piggy I am SO sorry for all your losses! The was my first and I honestly do not know if I’d make it through another, 5 must be… well unfathomable for me, I’m so sorry!!

I have had one dose, I was hoping it will remain just the one but the levels have stopped falling and next week they’re deciding whether to give me another dose or not. If they do, my 90 day countdown restarts and I just realllllly want to try for another baby!

The injection was in the top of my bum!

[piggycz]

When is your next blood draw? I hope your levels go down! No folate, vitamins or folate rich foods like spinach.
I totally understand not wanting to have to wait another 90 days to try again.
Are you still feeling pain? The radiologist told me the pain is most likely due to the cyst.

[piggycz]

Just to share, my injections were 2 doses. The first dose was 2 shots one on each side close to my lower back and then my second dose was oalso 2 sides on the upper buttocks. The doses were 3 days apart, and my doctor said it was normal for my hcg to go up before going back down. So I got my second dose today and my bloodwork today was 1200. Praying for us, for this to just be over already

[Elephant+1]

Next bloods are on Tuesday, I’ve been hoping for double digits for the last 3 tests, maybe this time I’ll get it! And yeah I’ve avoided foods high in folate, feeling so unhealthy now!

What country are you in? You seemed to have 4 shots? I had one in the buttock almost 6 weeks ago and they said they’d only give a second if this one didn’t work!

Hopefully yours now fall rapidly! When is your next blood draw?

[Elephant+1]

And yes, still in pain but it’s entirely from the cyst! I am on cocodamol to manage it, it’s mad that I miss the days where I was only worrying about an ectopic. The cyst and covid and added a whole level of complications and pain that I could have really done without

[piggycz]

My next bloods are also on Tuesday!

I am in the US. Are you in the UK?
It does seem like one dose has caused your levels to drop and really hoping that you won’t need another. These shots are definitely not the friendliest.

I have a sensation on the ectopic side and its hard to tell if its the cyst or if the ectopic is still growing. Won’t know until tuesday, good luck to us!

[Elephant+1]

So crazy that we are both humans with the same sex organs but because we live in different countries we have different treatment! It makes no sense to me?! Are we doing it wrong in the U.K.?! If I was in America would this have been over for me by now!?

Good luck for Tuesday! My bloods are Tuesday too! Hoping for good news for us both!

And I hope your cyst stops giving you grief soon!

[Elephant+1]

Hey!
My bloods are back!! They went from 136 Last Tuesday to 20 today! OMG I AN ACTUALLY CRYING the end is in sight 🥹🥹🥹
It’s taken 6 weeks today to get to such low figures, one more week and hopefully I’ll be discharged
Honestly so shocked and so happy!


Sending my love to you and I hope you get a good result today!!!! Xxxxx