I have a failed pregnancy and my clinic is recommending that I take methotrexate even though no etopic pregnancy has been located.
I hesitate to take methotrexate if it is not necessary and am wondering if ladies who have experienced miscarriages/taken methotrexate can give their opinion:
- would you take methotrexate if you were in my situation (see facts below)? Why or why not? Would this change if you knew for sure it was intrauterine?
- What questions would you ask or tests might you request in order to determine whether this pregnancy is intrauterine or ectopic, and is this determination important? i.e., would another u/s be helpful here now that my levels are >1000 and its 8 days later (total of 8w5d)?
- If it is a failed intrauterine pregnancy, is methotrexate ever indicated?
- How long did it take your levels of HCG to go back to zero after you took methotrexate? Does anyone know from personal experience that taking methotrexate helped their HCG levels decrease more rapidly than they would have if they had not taken the drug? Does this change if it is IU rather than ectopic?
In hindsight, I am also wondering:
- Might an earlier u/s (in the 5th or 6th week) have increased the chance that the doctors locate this pregnancy if it was intrauterine?
- Could a pathology lab help determine whether the material passed with my period was, in fact, pregnancy related and therefore indicate that the pregnancy was in fact intrauterine?
- Is there anything I can request or do to prevent this from happening again?
Here are the facts:
1st trimester u/s at 7w4d: IVF clinic was unable to locate the embryo that was implanted. The u/s results were reported as inconclusive. The pregnancy was not seen in the uterus or anywhere outside.
Two clinic doctors indicated that I most likely had a failed intrauterine pregnancy that has not fully expelled the placental tissue. However they note that there is a chance (small) that it is an etopic, but they cannot find it. They have ony done one u/s at 7w4d and do not plan to do any additional u/s (8 days have passed since the first u/s).
My hcg levels are low (750–>1030 over a week period and 3 blood draws) and are continuing to rise slightly even though I ended progesterone and finished my period. I swear that the period contained significant pregnancy-related material (grey tissue with vascularization and a kidney bean looking thing (~1.1cm) that was attached to the grey matter by a chord.) The doctor did not want me to bring the material in for pathology to examine it. But I wonder: Could the pathology analysis have answered the question of whether it was IU or not?
I am not having severe cramping, and the bleeding has largely stopped. I feel occasional cramps which are sometimes followed by additional spotting.
Thank you kindly for your thoughts… I have learned a lot from you ladies out there and appreciate hearing your experiences.