Methotrexate no day 4 blood test

[Sofia2442]

Thoughts and advice please.
I had 48 hour bloods showing my hcg went from 2000 to 3000. Multiple scans and they couldn't find the baby so said it was eptopic. They suspected it was next to my ovary but couldnt comfirm. Advised to get methotrexate.

They day after the 3000hcg it jumped to 4100. This was a day before the injection. They didn't do a 4day blood test as they said it will increase anyways. My 7day blood test was yesterday and they said my hcg is now 4000 and that this is good and nothing to worry about. They told me to come again for bloods 7days later. What do you guys think please advise.

[Headspace2020]

I’d say it’s unusual not to have day 4 then day 7 bloods - and instead day 7 and 14.
It seems a long time in between monitoring. Also, I know they check your liver count etc after the methotrexate not just you hcg.

Mine rose on day 4, only decreased by 3% on day 7 and by day 9 it plummeted so I would caveat the usual day 4&7 not always being helpful for everyone given my experience however those days do seem to be the normal testing points.

Personally, if it was me, I’d ask for more frequent monitoring given the fact, regardless of methotrexate rupture is still a risk - also id have sent myself sick with wondering and worrying.
I know previously before I had the methotrexate, they told me to come back in 7 days for bloods, I generally declined this ad said I’d be back day 4/5 at most as I just couldn’t cope with such long periods of being left. There’s nothing to stop you presenting earlier than 7 days for more bloods.

Do what feels right for you, if you feel too worried to wait, then don’t!

[EPT Host 20]

Dear Sofia,
I am so sorry to hear of your ectopic pregnancy loss,
We would usually advise day 4 bloods. The day 4 and 7 blood tests are used to look for a 15% drop between the 2 readings to check the treatment is working. Without the day 4 result this is difficult to tell. Bloods are then monitored every 3-7 days, beta hCG to ensure that they are falling appropriately. Most 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 would perhaps push for another set of bloods before day 7.
I would also be led by any worsening signs of symptoms and if you experience worsening pain or bleeding or start to develop shoulder tip pain or feel dizzy and unwell, please return for urgent medical advice.
I hope the next blood tests will show a reduction,
Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
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