I am currently waiting for theatre. All this has happened very quickly. I had an US this morning 5w2d and I have an ectopic. My FS says it is better to remove the tube as it can occur again in the same spot if it is left. She didn't seem to keen on the Methotrexate option.
I am running out if time to decide...
So sorry to hear you have such a tough decision to make. I have looked after many women who have Methotexate and do fine with TTC again. Worry of taking a tube of course you don't know if both tubes work so could effect future fertility.
How much physical pain are you in?? as pain is another deciding factor on treatment options as well as size of ectopic.
Huge hugs I hope what ever you decide goes well for you xoxo
I'm so sorry you're going through this. I'm not sure how fast methotrexate works. I do know it wipes out your folate levels, so you need to delay TTC for at least 3 months after taking it.
I am not in a huge amount of pain, just constant period pain on the left side. They said there is fluid around the sac. Also I ovulated on both sides but not sure of I always ovulate both sides.
TilyGirl I'm so sorry. Ive had surgical treatment for an ectopic in 2009. I also work as a midwife so have nursed both methotrexate and surgery.
I had a suspected ectopic 5months before I had my tube removed. It resolved on its own but my next pregnancy was definate ectopic (ovulated same side) so my 1st ?ectopic only blocked the tube for the next time. The policy where I work is if the BHCG is under 4000 and there is no freefluid (except whats normal anyway) then methotrexate is often the choice over surgery. I didn't have a choice because of the amount of freefluid in my abdomen and level of HCG.
If you go with methotreate then you can't start ttc again for a min of 3 months if not much longer especially if you need more then one shot to disolve the pregnancy. You can potentially maintain your fertility this way however but there is still a risk that your tube will remain blocked even after treatment.
Benefits of surgery is although you need to wait to heal you can generally start ttc sooner if thats what you want. You also dont need all the regular BHCG checks you will have with the methotrexate whilst waiting for the BHCG to go below 5. You can also possibly ask them to check your other tube with dye so you can check the health of that tube whilst they are in there. This may not be possible however.
With ne it was found with my surgery that my tube with my ectopic was sick and it had been for a while which had caused recurrent m/c (as it was toxic so was poisoning any pregnancy I managed and causing m/c or not implanting at all) my tube had to come out either way one to treat the ectopic and secondly for me to then go on to have a successful next pregnancy which I did 12months later conceived naturally.
I'm now ttc again and its a little frustrating however only having one tube which I know is damaged. Part of me thinks if I had two tubes Id have better chances so that sucks abit. The only other thing I guess thats important to know is if you are treated with methotrexate there is a chance your tube will still rupture and need removing anyway. Ive also heard of a few cases of methotrexate causing nuchal tube defects so I guess if you dont go down that path then your risks are no greater then they currently would be.
Methotrexate acts by depleting folate levels which folate is needed to feed rapidly dividing cells like you find in pregnancy and cancers. By reducing folate then certain cancers and pregnancy can disolve as you have taken the food source away. So thats why when you want to ttc again its really important to have your folate levels at a desirable level again so your not at a huge risk of nuchal tube defects in the future.
Hope this helps. Once again I am so sorry your going through this xxx
I had my tube removed. I was over 9 weeks and had ruptured so no choice, or die I guess. I conceive 2months later. The egg came from my side if lost the tube. The dr just said that the tube that's left does all the work. The body is magical.
My tube couldn't be saved due to the fluid around the sac and some area of necrosis. Feeling very deflated, it's seems if something can go wrong it will!
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Theatre or methotrexate?
xxx
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