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I had an ectopic at the beginning of December. My hcg levels are steadily going down after receiving two shots of methotrexate. Last I heard they were at 400. It seems like it has been such a long ordeal but I think it was a better choice than having the surgery and getting the tube removed! I continue to bleed even 20 days after the last shot and I have some pretty bad cramping that comes and goes. Also, it is painful to go to the bathroom at times! I'm tired all the time which is probably from the loss of so much blood.

My doctor has told me to wait at least 3 months before ttc. I badly want to try sooner. However, I have done some research of my own on this issue. I have found an article in the Oxford Journal of Medicine. It advises to wait 6 months before ttc as the methotrexate has been shown to remain in the system for that long. The article is filled with medical terminology so it is a little difficult to read but here is a quote from the summary which is a bit more straightforward:

"Women should be warned that there may be a small increased risk of spontaneous abortion early in pregnancy, and advised against taking MTX if they are considering conception. Those who choose to stop MTX and proceed to pregnancy should be advised against conception within 6 months of taking MTX. In the event of conception within this time, full counselling and close fetal monitoring should be offered. "

Also:

"MTX treatment is unlikely to have a major effect on short- or long-term fertility in men and women, but a washout period of 6 months cessation of treatment prior to conception is advisable to prevent the small chance of chromosomal abnormalities in offspring"

Unfortunately, this site will not let me post a URL but the article is entitled "The effects of methotrexate on pregnancy, fertility and lactation." It is from 1999, Volume 92, Number 10, page 551-563.

From what I understand, methotrexate eliminates the folic acid in your body so if you were to conceive soon after the shot it would probably be similar to not having taken prenatal vitamins with folic acid. I think that 6 months is a little extreme but we will try to wait that long in order to give our baby the best chance. For those of you that didn't, I'm sure your pregnancy will be successsful as so many people do not take the vitamins while pregnant and end up with perfect babies. God provides miracles in abundance!

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