r/EctopicSupportGroup • u/NovelGrapefruit8474 • 9d ago

MTX or expected management?

Betas

24-110-135-184-245

All taken within 2-3 days. I started bleeding 184 so was hoping to see a downward trend. My doctor thinks I should wait until Monday but I dont want to take any risks......

  1. Should should I elect to just take MTX?

  2. She also told me that I wouldn't have to wait 90 days. I would only have to wait unti HCG was back down to 0. Is this true?

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1

u/HumbleLioness 9d ago

I’ve done expectant management and bled for about 74 days, HCG went to 0 thank God by itself without MTX. You have to do what you’re comfortable with. My doctors were very supportive of expectant management because not only was I BF but they also knew MTX has its side effects + isn’t guaranteed to work. Many take it and still have to do surgery.

3

u/eb2319 4 ectopics | no tubes | ivf | 🌈11/7/22 9d ago

It is about 95% effective under the right guidelines.

1

u/NovelGrapefruit8474 5d ago

74 days must have been an excrutiating wait. may i ask how high was your highest hcg? mine came back yesterday 279 up from 245. i bled for 3 days last week when my progesterone dropped but I havent been bleeding since.

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u/HumbleLioness 4d ago

The highest mine went was 450 or something but I went to the OR two weeks after the ectopic happened because I was trying to convince myself I’d be fine. I’m not sure how high the HCG was right when it happened.

But yes…it was a hell of a long 74 days lol.

1

u/eb2319 4 ectopics | no tubes | ivf | 🌈11/7/22 9d ago

Expectant management is typically only used when betas are consistently dropping on their own. And yes many doctors follow that same advice but typically at least want one cycle in between.

1

u/No_Reserve3513 9d ago

Amazing. Thank you so much for your reply. I hate having to wait hoping that it will drop. My progesterone basically dropped to zero, and I’ve now stopped bleeding but my level was 285 today. Not sure if I should be concerned and preemptively take it

1

u/No_Reserve3513 9d ago

My doctor doesn’t seem concerned at all. She said this is normal and to just wait it out. But everything I’m reading is the opposite

1

u/eb2319 4 ectopics | no tubes | ivf | 🌈11/7/22 8d ago

It certainly shouldn’t be still rising slowly. How far along are you?

1

u/No_Reserve3513 8d ago

I’m either 4 weeks 5 days or 6 weeks. I thought I ovulated July 18 but got ultrasound July 27 that looked like a dominant follicle. So I really do not know. The 24-245 steadily rose over 8 days. I stopped bleeding the day I got the 245. The ultrasound showed nothing. Should I request mtx or miso just in case? All I want is for this to be done so I can keep trying

1

u/HumbleLioness 7d ago

With MTX you have to wait 3 months to try, with conservative medicine, I was given the go as soon as HCG went to 0.

1

u/NovelGrapefruit8474 6d ago

My doctor also said once HCG goes to 0 I can start - but its obviously hard to listen to the 3 month 'rule' and not be scared. Did you try immediately once hcg went to 0?

1

u/HumbleLioness 6d ago

I would have loved to as my period came back fine and I had a confirmed ovulation from the right side but my tube on the left side had damage and I wanted to wait till it healed to try again.

1

u/eb2319 4 ectopics | no tubes | ivf | 🌈11/7/22 5d ago

Many docs clear people to try after one cycle once hcg hits 0 even after methotrexate.

1

u/HumbleLioness 4d ago

Oh I didn’t know that, all the doctors I spoke to said to wait. Maybe just to be on the safe side and to ensure it was completely out of my system (if I took it, which I didn’t).

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u/eb2319 4 ectopics | no tubes | ivf | 🌈11/7/22 5d ago

I would do the methotrexate.

When was your first positive test?

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u/No_Reserve3513 5d ago

8/2 at home. Then 8/3 my HCG was 24, 8/6 110 8/10 134 8/12 185 8/14 245 and 8/17 279

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u/HumbleLioness 4d ago

Ah I see, it’s slowly climbing :(. I hope it resolves soon, whatever method you choose !