molar pregnancy following methotrexate treatment?

[thirty_five]

I am 35 years old. My doctor suspected ectopic pregnancy when an ultrasound revealed no gestational sack.

This is how it happened. Immediately after finding out I was pregnant (3 days of late period) I took a low dose of Methotrexate (25mg) and Misoprostol. Since I didn't get any bleeding following taking this medicine (which, incidentally was not given to me by a doctor but by a pharmacist friend) I had an appointment with my OBGYN and explained my situation.

Blood tests revealed still elevated levels of hCG and the ultransound revealed no gestational sack. Ectopic pregnancy was suspected but not confirmed and the single dose methotrexate (102mg based on body weight) treatment was prescribed. After 4 days and by day 7 the hCG had not dropped 15%. A second dose of methotrexate treatment was adminstered (102.5mg). Still, hCG had not dropped, it has slightly increased from 370 to 450.

The doctor just called and is sending me to an oncologist who is also a gynecologist. She said not to worry because this is not necessarily cancer. Rather, she is sending me to this doctor for a two week treatment of daily methotrexate. I have an appointment with him in a week, it was the soonest I could get. I started reading up on this issue and I am worried it could be a cancerous molar pregnancy. I am wondering if the low hCG levels I am having of under 500 could possibly indicate anything really bad like this? I am also wondering if there is any other test I should be given before the 2-week methotrexate treatment? Why is the doctor not prescribing a d&c, is it because no gestational sack was detected during the ultrasound? I read that methotrexate should be administered with an antidote that lowers the side effects of methotrexate. I am wondering why I haven't been given this option by my doctor? After these 3 doses of methotrexate in the past month I am already noticing considerable hair loss and swollen eyelids which, I read, could both be side effects of methotrexate.

[alikat1205]

i also don't understand.  at 3 days late, there would be no sac to see, nothing to indicate there was anything wrong.  also since your numbers were going up, that indicates that things were going right.  were you trying to miscarry?  i'm confused.

[tina1111]

I am confused. You say 3 days after missed period you took methotrexate given to you by a pharmacist friend? I am assuming this is b4 seeing your dr? Did you not want the baby? At 17dpo (3days after missed period) nothing would be seen on an u/s other than possibly a thickened lining.  At what gestational age was the pregnancy at the last u/s?

A dr won't do a d&c if it is an ectopic. If it is molar or partial molar, it is usually indicated by rapid rising Hcg and something would be seen in the uterus. They normally spontaneoulsy end. In some rare cases they can metastasize. If this were happening, an u/s should show it. Also, since methotrexate is a form of chemotherapy, if given in multiple doses, an oncologist is often called in. They should also monitor you with CT scans if they suspect it is spreading. Are they going to do another u/s soon?