Question Title: Bad decision?Ended pregnancy that was most likely ectopic-now feeling guilty

I am so thankful for your help-I am looking for some HONESTY please(not reassurance) from a DR. that does not have to give guarded answers. I need to know if I acted too hastily in making a decision that I now believe will always haunt me. (Dates):
Apr.1,1999 normal period
Apr. 17-19 last dates of intimacy
Apr. 26 yearly exam,PAP test
Apr.29,period(28days (and by 9a.m. as usual)lasting 3 days)

MAY 7 I started spotting and took a preg. test-light pos., called Dr. because I had 2 previous ectopic preg.(lost the rt. tube/surgery in 94 and had Methotrexate in 97) had the same symptoms-no missed period and I started spotting a week later. I also had a fever of 100-101 that lasted until a few days ago(Dr. said it was from sinuses?). I went Mon. May 10 for HCG (70), Wed HCG (4,882), Thurs.(May13) they wanted to do a laparoscopy(?) but I refused because I only have the one tube left and after last lap. I woke up missing a tube. They did the blood work so I could have Meth. on Fri.. Friday I went to get Meth. shot-but HCG came back 242(Wed. was a lab error) they said I needed to do an HCG on Sat. then again on Mon. along with an ultrasound and then on Tues. I could have Meth.. I knew these levels were too low for a 6 week preg.(or they seemed to be after a 6 hr. search on the internet for HCG levels) I was scared to death that I would lose my fertility or my life if I waited(they told me to keep a phone with me so I could call 911 if my tube burst!!) I went straight to my RE who I had not seen since my first normal preg.(I have 2 boys 3 and 1) and begged for his help. No one had any definite answers but he expressed the"If it walks like a duck, talks like a duck " opinion and called my Dr. who decided that he would give Methotrexate on Sat. if those values were not high enough. Sat. HCG(382) - (Thurs.-2 days earlier(242)) he said the level rose enough that it could be a normal preg but my dates would have to be off by about two weeks. Because of my yearly exam I knew that this was not possible. Because of my past history, the low HCG #s, the slow rise of HCG, the bleeding, definite dates of last intimacy and what was on the line I decided to go ahead with the Meth. even though he said there could still be a viable preg. although unlikely. NOW I can't help but wonder if I acted too hastily-my husband does not want more children but I know that I would get rid of him before I would end a pregnancy so I know that that didn't influence my decision. I am afraid that fear outweighed common sense and patience and that I may have ended a viable preg.. My Dr. and the Nurse Practitioner will not comment one way or the other. I need to know honestly if I made a mistake. I need some kind of closure(not reassurance) - I will deal with it if I made a mistake - I just need to know. PLEASE give me your honest opinion from the info. I provided. Just a couple more questions(sorry about the length)- I just had the Methotrexate on Sat. - 2p.m. which stopped my spotting completely -now it's Fri. morning and I have not had any cramps or bleeding- Wed. the nurse said that I HAVE to bleed from the Methotrexate - how long will I have to wait for this to happen - last time it was within 24hrs.?? Also, my HCG count this Wed.(May 21) is 990 why would the count go up 4 days after Methotrexate?? Are there any other factors related to ectopics besides having damaged tubes(which mine probably is) -this was unplanned so I was not taking care of myself. I skipped entire nights of sleep in order to study, I was taking various pills, vitamins, etc. prescribed for weight loss and I have been under a lot of stress - could this have caused the problems? Last one (I promise) Despite the use of the diet pills and no appetite I have gained approx. 16 lbs. these past 40 days any ideas what could cause this? Thank you so much, ahead, for taking the time to answer my(many)questions. My family will benefit greatly from the peace of mind your help will provide! Thank you !!!!!

Dear EAH:
The hCG pattern you present: 5/10, 70 mIU/ml; 5/13, 242 mIU/ml; 5/15, 382 mIU/ml is beginning to show an abnormal pattern. Although absolute hCG levels must be judged within the context of "normal for that laboratory", the values seem low for a "6-weeks from last normal menstrual period" pregnancy.

In a patient who is having symptoms of an ectopic pregnancy (and any woman who tells you she has the same thing she had before must be believed), these values are good reason to investigate (laparoscopy) and/or treat (surgery or methotrexate) the presumed diagnosis of ectopic pregnancy.

Trophoblast is not always erased by a single treatment of methotrexate. One set of laboratory values were in error: when the lab does not fit the clinical situation, it needs to be repeated.

Tubal damage is the recognized contributor to ectopic pregnancy.

Weight gain occurs because on is eating or retaining fluid. Anxious and/or depressed persons have no appetite, are not eating, and sleep poorly, and have poor recall of food/fluid intake patterns.

Keywords: methotrexate treatment, ectopic pregnancy

This information is provided for education purposes and is not a medical consutlation. If you have specific questions, please speak with your healthcare provider.