If you had an ectopic, please come in....

sescms2004

It is looking like my current chemical pregnancy is now ectopic.  The levels are low, but I had 3 ? days of heavy bleeding, and then they started to creep up.  U/S showed my lining to be very thin, so RE is confident it is not in my uterus.   Beta #1 ? 48, Beta #2 = 52, Beta #3 (four days after beta 2) = 63.  He?s having me come back on Thursday for another beta, and if it?s still creeping up, he wants to do Methotrexate. 

 

I am very concerned about Methotrexate, and do NOT want to do it, if there?s a chance we might not have to.  My main concerns are that we?ll now have to take a prolonged break, and I just had my lap done to remove endo.  These next few months were supposed to be the best time for us to try.  Also, there seems to be some debate on how long of a break you should take.  I?m reading that most RE?s recommend 1-3 months.  However, there is one RE in the clinic I go to who has read studies that MTX can have an impact up to SIX months.  These studies have shown it to reduce egg quality & count, and negatively impact endometrial lining function.  I already have DOR (despite being only 33), and apparent egg quality issues after 4 c/p?s now.  I really can?t afford to do anything to further impact this.

 

However, I do realize that ectopics can be life-threatening, and it?s certainly not worth the risk.  But, I?ve also read that you?re not really at risk for rupture until beta levels reach at least 500.  I think I would like to wait for at least a few more betas?maybe over another week or so?and see what happens.  I would be 5 wks pg today, but my level yesterday was only 63. 

 

If you?ve had an ectopic ? how long did you have to wait after taking MTX?  Did you notice any negative impacts in your next cycle?  What was your beta level when you took MTX?  If you have any other advice to share, please do.  I am really searching for answers and options at this point.

micheleleigh

I am so sorry. I haven't had an ectopic, but I just wanted to run an idea by you about the endo thing. If you are forced to take a break, you can go on birth control pills for those months to suppress the endo. I did this from January-October 2008, after my laparotomy to remove a large number of endometriomas and cysts. I did have a couple of small cysts in September (that went away on their own), but my OB and RE are confident that the BCP suppressed the endo tissue from growing back. Good Luck!

samk213

I took the Meth shot at the end of last September.  I was 7 weeks pg with a live ectopic in my left tube, my beta at the time of the shot was 3000.  I got a BFP and my betas started off low and non-doubling, Re thought it would be a chemical pg or blighted ovum, and hopefully I'd m/c on my own.  We kept monitoring with betas for the next 3 weeks.  I never had any bleeding or pain liek what some people describe, just sore boobs like a regular pregnancy.  At almost 7 weeks I did an u/s to see what was going on and that's when we saw the live ectopic in my tube.  At that point, I had to either make the decision for surgery to remove it or the meth shot, I was in danger at that time of it rupturing, and it still could even with the shot.  I chose the shot over surgery. 1 shot worked for me and we took a 3 month break.  The meth shot completely depletes your body of folic acid, is hard on your liver and because of that REs say to take the 3 month break so you can build up your health and folic acid again.  You do not take prenatals or folic acid until your beta comes back down to 0, which took me about 2.5 weeks from the date of the shot.  Basically I chose the shot because I didn't want surgery or to risk losing a tube through surgery or scar tissue in that tube, I took the risk of it rupturiing anyway with just meth, but it worked for us.  If I'd chosen surgery, I could have cycled in a month after AF came, but I really needed a bit of a break after the ectopic anyway.  We've moved on to IVF since the tube that had the ectopic we later found out has a polyp which probably caused the ectopic, so I'm just bypassing both my tubes from now on. 

I wish you the best of luck and I'm sorry you have to go through this.  Don't wait to long listen to your Dr and I know you'll make the best possible decision with such an impossible situation.

mybobble

Ectopic was discovered at 6.5 wks (I had an iui, that's how I got pg). I had heavy black clotting (tmi, sorry) but that's it. My beta levels were increasing the way they should be so when it was discovered that it was an ectopic my re was floored. I believe my highest beta was around 4000! So not your typical ectopic numbers.

I was given 2 mexotrexate shots and had to wait 3 full cycles before ttc again. While we wanted to jump right into it we knew why we couldn't. We waited the 3 months and started treatments again. If you can avoid the surgery get the shots. Sure the side effects aren't pleasant but it's nothing like surgery.

Im sorry you are going through this. Dealing w/ i/f is hard enough and then having to deal w/ an ectopic after you've worked so hard really sucks. Big hugs to you!

futuremrsmikea

I had the shot in Nov. 2007 and we took a 3 month break, because the shot does prevent your body from absorbing folic acid. I was 7weeks when I had the shot but my levels were around 8000. Unfortunately the shot had the opposite effect (inflammed the cells) and my tube ruptured. But that is not usual from what I understand. Looking back I should have just had the surgery to start with and not worried with the shot, but with your numbers so low, I would opt for the shot. It works for a lot (if not most) people. I haven't found anyone else that had it and ended up in surgery anyways. I'll be thinking of you

Dr.Loretta

I would strongly encourage the MTX.

My betas were 15, 21, 26, and 100 (after a week between b/w). they couldn't find anything in my uterus on u/s (but really, with a beta of 100?). I was told at the 100 mark to come in for MTX. In the week between 26 and 100, I was told to look out for any signs of an ectopic, including bad abdominal or shoulder pain (the shoulder pain is a sign of internal bleeding).

In my way of thinking, I'd rather wait a few cycles to TTC again than potentially lose a tube or worse because we waited to see what was going on. My ob/gyn was adamant that she and all of her fellow drs. would not have let me wait it out any longer than I did. One would have done a D&C, but she was not in that camp (thank goodness).

I was told to wait 1 full cycle after taking MTX, though the RE I saw afterward preferred 3. I had no negative impacts in my next cycle. I got a BFP on 2/19 (13dpo), started bleeding a few days later, my beta was 100 in early March, u/s showed nothing, got MTX. I waited the April cycle and started TTCing again in May. CP in early July. I don't know if the CP had anything to do with the MTX, since it was 3 months after the shots.

Just my 2c.

smilee

Well, I will give you the perspective of someone who had no choice but to have surgery: Do not wait.

Ectopic pregnancies are VERY serious. ? Sure, waiting to TTC stinks, but your health and safety ?are far more important.?

By know means do I mean to scare you, but in the grand scheme of things waiting seems like a small price to pay for your safety.?