Methotrexate for Ectopic

Can you tell me the waiting period after a methotrexate shot for an EP?  My doctor mentioned 3 months and then 6 months.  I have had only 1 dose, (1 shot in each cheek)  My HCG level was 43,  14 days after an egg retrival for a 3 day transfer with IVF.  I am hoping it is not 6 months as my FSH level at last check a few months ago was 11.7 and it has been quickly rising over the last year from 6.2.  Also could this EP be a result of my stage 4 endometriosis for which I had extensive surgery over a year ago.  Thank you

[Elaine Brown, MD]

HI!
The half life of methotrexate is in the range of 12 hours.  Therefore, it should have been completely cleared from your system by approximately 24 hours.  In light of this, I don't think that there is really any reason to wait beyond one cycle to try again for pregnancy.

Yes, your endometriosis is very likely the culprit--it has probably caused scarring of the fallopian tubes, and that is what resulted in the abnormal implantation. There is a rather high baseline ectopic rate with IVF anyway, and the reason is not clearly understood.

If your RE has a good reason to wait longer than one cycle, you should definitely listen to his/her opinion, but I don't think there is much indication to wait 6 months certainly!

Good luck!
Dr B

[boolie]

Thank you so much.  I will ask him about it.  I wonder if I should have more surgery

[jamaicababy]

Hi i too had my first ectopic nearly 4 years ago the diagnosis pregnancy with unknown location.. i did the methotrexate treatment for 5 days after which my doc said we could not try for 6 to 12 months.. we waited more than 12 months unfortunately we had another ectopic which resulted in my losing a tube... i would wait the 6 months let your body fully recover and get all the drugs out. good luck

[dscoqn]

Wow I think waiting 6 months to 1 year is rather extreme.  When I had the injection I was told I only had to wait 3 months.

[seattleview]

My doctor also said there really was no reason to wait and that we could try the very next cycle if we wished.