XP- ectopic pregnancy and methotrexate

MrsHest09

Hey ladies. I posted a little over a week ago about having an ectopic pregnancy and having to have methotrexate injections. I had the injections last Monday, the 19th. On the day of the injections my hcg level was at 30...when I went back on Friday my level was at 21, and then when I went back yesterday my level had gone up to 24. The Dr. just called and talked to me about my options. She was very surprised that the methotrexate didn't work since my numbers were so low, and she offered me three options. One of the options, and the one I decided on was another injection of methotrexate. But she also mentioned having a D&C to get rid of any tissue in my uterus and then giving me the methotrexate injections. She also said if I had the D&C she could view my tubes while I was under anesthesia. My question is...if she is pretty certain it is an ectopic pregnancy, what would be the point of having a D&C? The last option was to go ahead and have the laparoscopy surgery to remove the pregnancy tissue/mass (which they haven't been able to see in ultrasounds, so they aren't exactly sure where it is at). She also said it would be very rare, but there is a very small possibility the ectopic pregnancy turned into a cancerous tumor. She said she has never had a patient that this has happened to, and she didn't want to scare me, but she did want to make me aware to the possibility. She also said my whole situation is very rare, that ectopic pregnancy and the treatment of it doesn't usually drag out as long as this has. I went ahead and decided to just have another injection of methotrexate and pray that it gets rid of it and my levels return to zero. This has been going since November 13th, I'm just so ready for it to be over with.

CFjo2010

I'm so sorry you're experiencing all this. I didn't do the methotrexate injections with my ectopic; it was only caught because we thought I had an ovarian cyst and the pregnancy test proved otherwise. The ectopic didn't show up on any of the ultrasounds so I had a laparoscopy surgery immediately to find it. It was implanted right where my left Fallopian tube meets the uterus. As sad and devastating the ordeal was, I'm grateful we did the procedure promptly. The Dr said afterwards that had I waited any longer, my Fallopian tube would have ruptured and would have caused severe damage to my uterus as well. 

Try not to get too upset about some of the things your Dr is warning you about.  A lot of the is Dr's disclosing every possible scenario as to avoid any surprises later.  Hugs and prayers coming your way during this difficult time. 

RedRose84

I'm so very sorry for your loss.  **Hugs**

MrsKilduff

My levels were roughly the same as yours.....20, then 26, then 30.....My Doc kept putting it off as if I was just having a m/c.  After a week and a half I landed in the ER with excruciating pain- my tube had ruptured.  I had emergency surgery to remove the rupture of my left tube.  The doc also did a d/c while I was under but obviously nothing was found in my uterus.  I'd had to see you get to that point...I'd say have the surgery.

Trixie12

I'm sorry you're having to go through this. My ectopic was diagnosed in late November at 5 weeks. My HCG levels were increasing, but not like they should and they remained low (mine were in the 400s at diagnosis).  

The nurse at my OB's office kept telling me that they would not be able to see anything on u/s until my HCG was at 1,000 and that I was probably miscarrying. I knew deep down that I wasn't miscarrying and that it was most likely ectopic. I did end up going to a local ER a week after I started bleeding to see if they could determine if it was ectopic. They could not. According to the ultrasound report, my tubes looked normal. However, two days later, I went back to the ER, but this time at the Woman's Hospital and, lo and behold, they could definitely see the ectopic pregnancy. I think the difference had a lot to do with the experience level of the radiology department and hospital. 

I opted for the methotrexate shot as well. However, my numbers increased a week after the injection, and I had round 2 of the shot. Unfortunately, I ended up back in the ER the next week with internal bleeding. I had to have emergency surgery where they removed my right tube.

In your shoes, I would probably opt to go with another round of the methotrexate. I would caution you to listen to your body very closely though. I knew something was wrong when I started to have heavier cramping along with pelvic/rectal pressure. Also, one thing I noticed was that I was very tender to touch in my lower abdominal area which was something new. Even when I had cramping before, I never had pain to the touch. If anything is out of the ordinary, call your physician or go to the ER. 

ETA: Oops, I see you've already opted for the second methotrexate shot. I pray that the second shot will resolve the pregnancy. 

BellaFamily

Hugs coming your way! I am actually two days behind u in treatment. I had my first shot on the 22nd and found out today my levels went from 3,000 last week to 9,000! tomorrow I will be getting round two! I am keeping my fingers crossed this shot works! If not I will have surgery as we were able to see the sac and baby in my left tube. The good thing is that there is no heart beat so hopefully it is ready to leave the body. Another risky situation I am in is that it is almost the size of when it usually ruptures. I am a little scared! Hoping this ends for us soon!!! 

kjennnn

I think the 2nd shot was a good choice (just my opinion though). My dr didn't want to do surgery b/c we couldn't see where the pregnancy was, and it could have even implanted in my abdomen, so she would be just 'looking around' for it which I wasn't comfortable with. My levels were still increasing too, and I had to get the 2nd shot (but my levels were in the 8000's, I think MTX is more effective at lower #'s too). It ended up working for me, I hope it does for you as well. Just be sure to get any pains checked out, take it easy, don't strain yourself, etc.

MrsHest09

Thank you all so much for the advice and for hearing your stories. I am new to this board, but will definitely be staying around. I feel like I have been so strong through all this, but the past few days I have been feeling so down and confused! I'm just so ready for my body to be back to normal. Hopefully, the methotrexate works and we are all able to get back on track soon!  

malderman1

I just went through this and my doc actually warned me that it is NORMAL for levels to spike after the first methotrexate shot - they actually anticipated that happening. My levels at peak were 1800 and all they were able to see on a vaginal ultrasound was a sac in my uterus o fetal pole or yolk sac and even looking at my tubes they couldn't see anything - so I did what you did, opted for the methotrexate x2 and now my numbers came down and last they were at 6. Don't be scared, your numbers are so low hopefully a second dose does the trick. Mine told me that they always do a second round of the shot because of it's efficacy hang in there, it's tough but we are here fr you