Anyone have Methotrexate? — The Bump
Miscarriage/Pregnancy Loss

Anyone have Methotrexate?

hi all!  Long story short, after hcg levels going up and down & 2 ultrasounds, I had a methotrexate injection on 2/24 which was a little over 2 weeks ago. But I'm still having bleeding (51 days now) and pain.  I'm struggling to know what pains are normal like my dr says and what I should be worried about.  I'm wondering if anyone has had the methotrexate injections and would be willing to talk about it. 

Re: Anyone have Methotrexate?

  • I had 6 methotrexate injections and did not have any strong cramping or pain.  Methotrexate was used in my situation to reabsorb the sac.  Have you considered seeking a second opinion?
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  • Have you had beta HCG draws since the methotrexate? You should be tested weekly or so until your HCG falls to zero, you are also still at high risk for rupture until you are a couple weeks out. It was also difficult for me in the early weeks to differentiate between corpus luteum cyst pain on the same side as the ectopic. Have you passed any decidual cast or tissue?

    I had both in-gestational sac and intramuscular methotrexate on 1/26 for a 7w5d cornual ectopic.

    Spotted 5 days, full on bleeding (CD1) and exructiating cramps in waves for 3 days before passing a piece of decidual cast (this was the worst of it), 6 more days of heavy bleeding without cramps, 5 days of spotting, 2 days of painful cramping and heavy bleeding and passed another piece of decidual cast, followed by 4 more days of spotting. 25 days total of bleeding and spotting since methotrexate injections, only 5 days painfully crampy.

    I ovulated on CD34 from temp chart, then had my first post-loss period kick off at only 7DPO with cramps (comparable to the 2nd surprise session and passing of more decidual cast) lasting all morning and passing a decent clot and no tissue. Needed a portable heating pad all day and naproxen.


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  • @justsuzie my dr was out for an emergency surgery so the nurse asked the other dr and she said it was normal 

    @GhanimaAtreides I have been getting weekly hcg testing. 703 to 699 on day 3, 547 on day 7. Then 235 a week later. And I'll find out today's in the morning.  I've been bleeding since I found out I was pregnant, 52 days ago. Varied between spotting and light, with medium flow 9 & 10 days after the shots.  I've had lots of clots the whole time (but I do during AF too). Nothing that looked like tissue I don't think (would I be able to for sure tell the difference?). I have had no cramping at all. 2 days after the injection, it hurt to press on that lower left side & I had twinges of pain but nothing excruciating.  Then last Friday (2 weeks after the shot), I noticed it still hurt to press on it and the next day I had sharp pain in and off. They would last for maybe half a minute, if that, but were frequent. The past 3 days, I feel like it hurts whenever there's pressure there (bending over, leaning against the counter).  Still nothing excruciating but still hurts.  I've also noticed I get really bad shooting pains when I have to go to the bathroom but it stops right away after I go. I e also felt extremely bloated--like I'm a balloon that's about to pop. And it's hard to describe, but sometimes when I sit down, it feels like everything being pushed up. I asked my dr for an ultrasound but she wants to see today's levels. I'm freaking out though because we're flying out on Friday to go to China for a week. After last weeks tests, my dr said to still continue with my travel plans. Did you have any pain like this?  I really wish I could have an ultrasound to put my mind at ease
  • I would call back and see if you can squeeze in an ultrasound or something definitive before the trip. I personally would not be traveling to a foreign country in that condition. I've heard of women with ectopics slow-leaking from pinhole tears prior to rupture.

    I had really bad (like vagal out, hot + cold + sweating + pukey) bowel movements and pain after my shots, but that's mostly due to having been put completely out with general anesthesia for them to ultrasound-guide the in-gestational sac methotrexate shot. It only lasted about 4 days post-op.
  • Btw I never passed anything and only had a few days of mild bleeding a few weeks before my first AF. Definitely go get an ultra sound. It will give you peace of mind. Take care. I'll be thinking of you. Ectopic are horrible and methotrexate is a nasty drug. 
  • Ok, so I just got done with what will hopefully be my last blood draw (it will definitely be <5).

    I guess at my office they to an SIS instead of an ultrasound to confirm whether there is retained products or not. But that might be due to the weird type of ectopic I had. I imagine if it was a tubal placement like yours, they'd do an HSG.
  • With mine, it was near the ovary the couldn't tell if it was in the tube near the ovary or actually on the ovary. 

    My my levels yesterday were 55 so that makes me happy. Going to get an ultrasound at 6pm and really hope I get a tech that will tell me something. 
  • @purplg8r hope you get some answers this evening. And glad your numbers are going down. 

    @GhanimaAtreides great news abou your numbers. Hope your cycle gets back on track. 
    GhanimaAtreides
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