Ectopic advice needed please

COkristi · August 2012

Hi ladies, I found out this morning that my miscarriage that started 3 weeks ago is actually an ectopic pregnancy. The more I find out about ectopic the more upset I get. I don't have any of the risk factors, and unlike a m/c, it's not common (only 2% of pregancies are ectopic), and it likely means something is wrong with my tube.

I go in tomorrow to get the methotrexate injection and am hoping that takes care of it so I don't lose the tube. I am 30 years old and this was my first pregnancy so now I don't know if I'll be able to have babies. Has anyone had an ectopic and have any advice about what to expect from the methotrexate, or any hopeful stories about having a healthy baby after an ectopic pregnancy? One statistic has only a 30% chance of a healthy pregnancy after an ectopic. Gah, the internet is not my friend right now.

Thanks in advance. Also, I wonder if they sell rum chata in Colorado. I would like to bury my face in that bottle right now.

killian09 · August 2012

There are a bunch of us ladies on here who have had ectopic pregnancies, myself included. I also have none of the risk factors, but unfortunately that doesn't make us immune.

It is completely possible to have a baby after an ectopic pregnancy. The rate of recurrence is around 10-15%, so the chances are pretty good that your next pregnancy will succeed.

Reactions to methotrexate treatment varies a lot from person-to-person, so it's a little hard to tell you what to expect. I'll say that the first 24 hours for me were pretty miserable--I was very dizzy and spiked a fever. I had a weird burning sensation in my abdomen off and on for several days. On day 4 after the injection, the pregnancy really started to end--my HCG dropped precipitously (by several thousand) over the course of 12 hours--and I was in truly excruciating pain. (I took two heavy duty painkillers, percocet, and was still just doubled over, crying out in pain.)

If you have pain like that, then go to the ER immediately. It can be a sign of ectopic rupture which is very dangerous. In my case, it was just caused by blood in my abdomen, but I did not need surgery. They did admit me, gave me a ton of morphine and IV fluids, and kept an eye on me for 24 hours. After that, things settled down.

...my experience was much worse than most though. Many women report few notable side effects from the drug. My HCG was 10,000 when I began MTX, so things weren't caught until pretty far along.

After MTX, you need to wait (probably for 3 months, but listen to your doctor) before TTC again. But once that passes, you are fine to try again. In a subsequent pregnancy, the doctor will monitor your HCG levels closely in early pregnancy so that any potential ectopic pregnancy can be detected early thus greatly reducing the risk of complications.

good luck! ((hugs)). sorry that you are going through this!

ETA:

for people describing successful pregnancies after an ectopic see this recent post on PGAL:

https://community.thebump.com/cs/ks/forums/thread/68024508.aspx

for medical information online, this site is very good:

https://www.ectopic.org.uk

...there is also a post on the TTCAL blog.

Another ETA: drink that rum now (but not too much!) bc you can't drink alcohol for a couple weeks after taking MTX. Also avoid any strenuous activity until the risk of rupture has gone away.

weaslewam · August 2012

I don't think the 30% is an accurate number. I haven't had an ectopic but my friend did and she was devastated. I'm sure if that was her diagnosis she would have said something like that to me. But really, your chances of getting pregnant again are very similar to your chances before the ectopic. You may just need to be more careful the next time you're pg to make sure the baby is implanting into the right places.

COkristi · August 2012

Killian, that was really, really helpful. I'm so sorry for what you've gone through. I appreciate you taking the time to respond to my questions and share your story. I will check out the links right now.

The dr thinks I will respond well to the injection because my levels are low. Hopefully that is the case. I'm sorry yours was so painful. They didn't tell me today about no booze for a couple weeks. That's a big kick in the gut, I'm glad you told me though. My appt is at 11am tomorrow and I took the day off work so I will make friends with a bottle of wine tonight.

COkristi · August 2012

Thanks w easler am, I was hoping that stat was wrong. I'm not thinking very rationally today and I need to stop googling! My doctor did say if I get pregnant again they will do early ultrasounds and monitor hcg so that is a little reassuring.

killian09 · August 2012

COkristi:
They didn't tell me today about no booze for a couple weeks. That's a big kick in the gut, I'm glad you told me though. My appt is at 11am tomorrow and I took the day off work so I will make friends with a bottle of wine tonight.

Yup--no booze sure adds insult to injury after not drinking due to pregnancy and then having that fail anyway. MTX takes a toll on your liver, so you have to avoid things that are also cleared that way. That means no alcohol and no NSAIDS (e.g. advil, aleve, aspirin) until your body has processed the MTX. So if you're going to have wine tonight, it's probably best to limit yourself so that your liver is ready for the onslaught it will get tomorrow from the MTX. [That's just my guess--my doctor didn't tell me anything about drinking *before* MTX, only *after*, but the MTX was administered to me within hours of getting the diagnosis, so there wasn't much time to drink anyway.] Hate to be a debbie downer though...

The "no strenuous activity" part means no sex too. And no going to the gym (according to my doctor).

I'm sure your doctor will talk to you about this tomorrow though and you can ask questions about what he/she recommends, but I think those restrictions are pretty commonly recommended.

I was told that it shouldn't be a problem for fertility (given that I haven't had fertility problems in the past). Even with one potentially blocked tube, the other one can still work! They said to go ahead and TTC for 9 months and then make an appointment if I'm not pregnant yet.

csspencer · August 2012

First of all, step away from the internet. It will only cause added stress...and obviously you have enough to stress about without the internet.

I too had an ectopic. And I too did not have any of the risk factors. From what my dr told me it's usually just a fluke.

I've had plenty of friends, and my MIL who have had an ectopic. My MIL went on to have 4 children after her's, and all of the friends I know who have had ectopics have had children since.

And I'm sorry for your loss.

ETA: I was given 2 doses of MTX, first dose, and then another 4 days later, but my levels were extremely high and I ended up with a rupture, so make sure you pay close attention to any pain. They should tell you at what pain level to come in...also, I had to have blood work done with each dose to check to make sure my liver was healthy enough. The MTX metabolizes in your liver.

LSzwaya · August 2012

I was given the MTX in early July for a suspected ectopic. I was told by my RE that an ectopic can occur because of existing tube damage OR if there was any random genetic issue with the egg and sperm which caused it to not navigate all the way to your tube. It is so hard to not go to the worst case scenario but try not to. I had lower levels, 153 when I had the shot and my levels decreased very quickly. I was given the clear to TTC after one normal cycle but I think thats only because my levels dropped very fast and by the time I ovulate again, I'll almost be at the 3 month wait any way. I felt kind of crummy for about 48 hours after my shot. But after that I felt much better. I am so very sorry you're going through this.

LeggyNic · August 2012

Sorry you are joining our ranks. Looks like Killian has given you some great advice and resources. Definately step away from Dr. Google. As you've already seen there are some great women on here with similar stories. Many have gone on to have successful pregnancies. My MIL had an ectopic and then 3 children in 5yrs.

I have 2 beautiful girls and my 3rd BFP ended up being ectopic. Since I wasn't in too much pain, my HCG levels were low and already declining, etc I was offered and opted for Expectant Management so I haven't had the methotrexate. Good luck to you!

COkristi · August 2012

I can't tell you how much your responses mean to me. Thank you for sharing your stories, advice, and info. It really helps to hear from women who know how this feels. The examples of ladies who have gone on to have successful pregnancies gives me hope. I am sorry you all are here and I am wishing you the absolute best!

Killian, the no alcohol and no exercise is going to super suck. Thanks for clueing me in, my doctor didn't mention that today. I'll limit myself on the wine tonight. Grudgingly .

PSU Export · August 2012

I also understand how you may be feeling. The situation itself and thoughts of the future can be daunting. My first pregnancy was also ectopic. I was devastated because we had been trying for almost a year. Thankfully I had the methotrexate and it was successful. It sounds like your tx will be successful as well. I felt pretty crummy for 2 days after the shots, but went to work anyway because I didn't want everyone to think I was dying. I never miss work. Stay home at least 2 days.

We somehow had a change in luck and conceived again 3 months later and now have a beautiful 2 year old. I recently had another miscarriage at 9 weeks but it was not ectopic. I hope this helps. Keep hope for the future and make sure your doc takes you at 6 weeks next time or earlier if you have any pain. I had pain the last time by it was apparently from a cyst on my ovary, which they say is normal from the ovulatory side.

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