Methotrexate and Ectopic

[JoesWife]

I found out that I was pregnant on 6/4/06 by going to the emergency room. I had a u/s on 6/8..my doctor said that it was another ectopic.  I have had 2 ectopics and 1 m/c previously. This ectopic was treated with methotrexate, the other 2 were remove by surgeries..one of which my right tube was removed.  I had the metho injection on 6/8, my hcg levels were 523. On 6/12, the hcg was 849, then 6/16 it was 622. On 6/22 I had my blood drawn again, and today I was told the level went up to 780.  Is this normal?  I had to have another methotrexate injection.  My husband and I are really concerned about the effects this drug has on my body.  Should we be concerned?  Since this last ectopic, my doctor has suggested IVF...we cannot really afford the cost, but we want to start our family.  Anyone have any advice.

[JoesWife]

Thanks for the info..I really appreciate it.  My first ectopic was in my left tube, which had to be removed.  The other two of course were in the right.  My doctor called me yesterday and said to come in on 6/30/06 so he can check my levels. Hopefully the second injection of metho worked, if not he said that he will have to do surgery.  I pray for the best...I am getting so tired of this.  It is emotionally and physically draining.  Thanks again...

[mslkpage]

First off, let me say I'm sorry for your losses. I had a m/c last year (blighted ovum) at 12 weeks. 5 months later, I was Dx'd with an ectopic at 7.5 weeks. Everything I've read on methotrexate states that the initial draw after the shot will likely be higher than before the shot. After that, however, they should all decrease. But you're not the first person that I've heard of needing a subsequent shot. Were both previous ectopics in your right tube? Before this pregnancy, did your doctor do an HSG to take a look at the left tube? If not, ask him to do one once your levels are back down to 0. Laproscopy is even better for checking the condition of your fallopian tube, since the HSG can miss things sometimes. If that tube is fine, then don't throw the towel in just yet. As far as the side effects from metho, I don't think you have anything to worry about. It does cause some abdominal discomfort and general feelings of "blah," but if you get to keep your tube, it's worth it. Good luck, and don't give up hope. Here's a link to an ectopic pregnancy group that can offer you more advice:

http://health.groups.yahoo.com/group/ectopicpregnancy/