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