Ectopic Pregnancy, Rhogam, Methotrexate and MC

razorbackbelle42

This is my first pregnancy. I've been bleeding for 5 days and the doctor called me today to tell me my HcG levels are still rising. Since they see nothing in the uterus, they think it's ectopic. I'm scheduled to take a methotrexate injection tomorrow. I received the rhogam injection on Monday (I'm O neg). I already have reduced ovarian reserve, so the fact that we got pregnant at all feels like a small miracle. I'm worried that with the reduced ovarian reserve + ectopic pregnancy + methotrexate that I might not be able to get pregnant again. Anyone else been through this?  

acunamatada

I'm very sorry for your loss and thay you've found yourself here. I'm not familiar with low ovarian reserve but I did have an ectopic in May and had laparoscopic surgery followed by MTX. I did a lot of research regarding MTX and I didn't see anything indicating a decrease in fertility due to the medication. From what I read MTX doesn't effect the quality of eggs post treatment but it does deplete your body of folic acid which are of course necessary for a healthy pregnancy. 
Your doctor will likely follow our hcg down to <5 and then you will be "benched" for 2-3 months/cycles depending on the doctor. Be gentle with yourself and give yourself time to heal. I am now two cycles post ectopic and finally feeling "normal." 

Mack2342

@razorbackbelle42. I'm so sorry for your loss.   I didn't have ectopic but do have low ovarian reserve.  I'm 42 and dr said it's normal range for someone my age.   I'm not sure the difference in my reserve from 39 to now as I never had it checked until recently but *****TW***** I got pregnant with my son at 39 and delivered at 40.  I've been pregnant twice since then both ending very early at 10wks and 8 wks.  I started seeing an RE and we have done 3 IUIs with femara. We will begin injections next cycle if this doesn't work.  Drs have said it's possible but difficult at my age.  

I hope you have a healthy recovery both physically and emotionally 

justsuzie

I am sorry for your loss as well.  I had an ectopic 9/16.  I had to have 6 shots of mtx because my ectopic was in a very dangerous place (cornual).  I did A LOT of research and it was always very contradictory.  Some reports said that MTX did in fact affect egg quality and others did not.  There just does not seem to be much research out there.  Some doctors say wait 3 months after the last shot, some say 3 months after first period. Others say 6 months.  My doctor said I needed to have 3 cycles or 3 months of time after first AF to get enough folic acid back to healthy levels. She also said to try to replenish with folate rich foods more than just taking a prenatal.  (I take methylfolate instead of folic acid now, but that's an entire other convo!) I didn't get my AF until 3 months after the injections and then had to wait another 3 months to replenish folate.  Good luck. Ectopics are rough. Make sure you take time to grieve.

jkhall2010

@razorbackbelle42 I'm sorry for your loss. In May I had an ectopic pregnancy and was given a methotrexate injection. I can't say much about the ovarian reserve, but I had methotrexate and an ectopic just a couple months ago and I am pregnant again now, 5 weeks, and it appears things are going smoothly this time around. First Dr appt is Aug 17th for a "viability ultra sound" to rule out another ectopic (only a 20% chance of having another ectopic due to the first one). I'm optimistic about my situation, but I would certainly bring up these questions to your Dr. 

justsuzie

Oh, and forgot to add I had 2 subsequent pregnancies that were not ectopic.  I stressed about having another ectopic even though I had no history that would warrant ectopic in the first place.  Try not to worry about another ectopic. ( I know easier said)

razorbackbelle42

How were you able to tell that the methotrexate was working? I started bleeding on 7/28. Had the methotrexate injection on 8/2. The bleeding and cramps got much heavier after the injections. It's now 8/6 and I'm barely bleeding, the cramps have subsided (mostly), but I'm still exhausted. I had blood taken on 8/5, but haven't heard back about my levels yet. I go have more blood taken tomorrow. I'm hoping that the easing of bleeding/cramps means that the injection worked and everything is clearing up. 

justsuzie

You can really only monitor after you track the HCG with blood tests.  I went every week for 3 months.  (A long time because my numbers were in the 20000's)  The doctors should check to make sure that the numbers are going down a steady rate because if not you may need a second shot.  I actually didn't bleed much at all until my Hcg was below 20.  That was 3 months later and I ended up passing a bunch of tissue which I assume was the POC.  Good luck. Ectopics are rough. My periods were also kind of wonky afterwards.  

baby_100

Hi my daughter had a m.c a week ago she has bicornuate uterus just. Wondering if she can stay pregnant or if this is going to keep happening to it was her first m.c she went in last thursday and had a ultrasound and they seen a heartbeat and went in the next day it was friday and the doc did not see one anymore and she just got her dand c done a few days ago