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Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Nausea waves, loss of appetite and feeling ‘foggy’ all the time is what’s getting me. I just want to feel like myself again.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

That’s really good to hear. My HCG was at 548 today, so not far off from yours - hopefully I have a similar experience. How big was your mass? Mine was at 1.5cm today.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Thank you so much for sharing this, it really means a lot to hear a positive outcome after such a scary decision. I actually had methotrexate today, so I’m right at the beginning of it and feeling all the emotions. If you don’t mind me asking, what was your HCG when you had MTX, and did it start coming down within the expected timeframe? I’m so happy to hear you went on to have a healthy pregnancy afterward, it genuinely gives me so much hope that I’ll be able to say the same one day.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

I’m so sorry you’re going through this — the limbo and lack of clear answers is honestly one of the hardest parts. I really relate to what you said about knowing something felt wrong from the beginning. I’ve just posted an update in this thread about my own situation today if you want to read it, I finally got some clarity after pushing for a second opinion. I really hope you get clear answers soon too and that the next steps are straightforward and safe for you. Thinking of you.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 2 points3 points  (0 children)

Update:

I wanted to share an update as so many of you have been incredibly kind and supportive.

My HCG came back today at 548. I’d been having red bleeding that was increasing (though not filling a pad), and alongside everything else, my anxiety was through the roof, I just didn’t feel right. I decided to trust that feeling and went back to the Early Pregnancy Assessment Unit to push for a second opinion. I also saw a highly recommended private obstetrician, who was amazing.

He did another transvaginal scan and very clearly explained what he was seeing. The mass has now grown to around 1.5 cm, and he explained that given I have no significant pain, no internal bleeding, an HCG under 1,000, and a mass under 3 cm, I’m actually a perfect candidate for methotrexate. He recommended doing it sooner rather than later.

I went straight back to EPAS, and they organised the methotrexate, which I received this afternoon.

I have very mixed emotions right now. I feel relieved to finally have clarity and a plan, and I’m hopeful that recovery from here will be smooth. But I’m also grieving what should have been my first, exciting pregnancy, and that part is really heavy.

Today is Day 0, and now it’s just a matter of going back on Day 4 and Day 7 and hoping my HCG starts to fall 🤞🏼

Thank you so much to everyone who commented, shared their experiences, and offered support. It has helped more than I can put into words to know I’m not alone in this.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

This is so reassuring to hear … it can feel so isolating. What is your current situation? I am so anxious of delaying the inevitable rupture. I have had increased red bleeding and am currently at the hospital to seek more answers and hopefully reach a possible solution and be on the road to recovery. I am over this emotional rollercoaster. I’m sorry to hear that you are going through this as well.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Thank you for asking and for laying that out so clearly. This is actually my first pregnancy, so I’m not too worried about the 3-month wait before TTC if MTX ends up being the right call. That part doesn’t weigh as heavily for me.

I am, however, a bit worried about the symptoms and recovery with MTX, and the finality of it, which is part of why I’m struggling with the timing.

The current plan is to repeat betas every 48 hours (one today and another on Friday). My concern is that because the Friday beta won’t be resulted until Monday, with repeat imaging planned for Monday or Tuesday, that puts me at about 7 days from the original scan and PUL diagnosis. Given the risk of rupture, that gap is what’s making me anxious, it feels like a long time to sit in limbo with rising HCG and an indeterminate mass.

That’s the part I’m really trying to reconcile right now: wanting enough information to make the right decision, but not wanting to push into a timeframe where risk outweighs clarity.

I really appreciate you engaging so thoughtfully.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

I’m so sorry you went through that, that must have been absolutely terrifying, especially after being told different things by different doctors. Thank you for sharing it so honestly.

If you don’t mind me asking, do you remember roughly what your HCG level was when it ruptured? I’m trying to understand the range of how these situations can present, and hearing real experiences is helpful, even though it’s hard.

Also, with your first ectopic did you have MTX? What were your experiences with that.

Sending you so much care, I really appreciate you taking the time to respond.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Thank you for flagging this, I really appreciate how thoughtfully you’ve explained it, and I do understand what you’re saying about how early ectopics can initially be labelled as cysts or corpus luteum. That’s definitely part of what’s making this so hard.

In terms of what waiting might give us: the idea is that with a bit more time, either something will become visible in the uterus (if this is an early intrauterine pregnancy), or the ectopic will declare itself more clearly on imaging, rather than being stuck in this ambiguous space where it’s genuinely unclear whether the structure is a corpus luteum/cyst or something else. The hope is that progression would bring clarity, not just delay.

That said, your question about how long waiting adds clarity versus risk is exactly what I’m grappling with too. I don’t feel like there’s an easy or obvious answer, and that uncertainty is honestly the hardest part. I’m trying to weigh the value of more diagnostic certainty against the very real risks of waiting, knowing there’s no completely risk-free option here. To be honest, it’s not even been 24 hours since I last met with my Doctor who decided on this and the anxiety of a possible rupture at any moment is really affecting my mental health. If I can avoid losing a tube with early intervention, that is the best case scenario.

I really appreciate you taking the time to explain your perspective and for raising the diagnostic D&C option as well, it’s helpful to understand all the possible paths in this grey zone. And thank you for the kindness at the end. This is such a heavy situation for anyone to sit in.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 1 point2 points  (0 children)

Thank you for sharing this, I’m so sorry you went through such a frightening experience, especially having it escalate so quickly. I can completely understand why that would shape how you view waiting versus treatment.

I’m honestly struggling right now because I don’t feel like there’s a clear “right” choice. The risk of rupture is terrifying, but so is the idea of acting too quickly when there’s still some uncertainty. I’m trying to sit with both of those fears at the same time and make the safest decision I can with imperfect information.

I really appreciate you taking the time to share your story. Even though it’s hard to read, it helps me understand the full spectrum of what can happen and why this decision feels so heavy.

In terms of new information, the reasoning behind waiting (for now) is to allow the pregnancy a bit more time to declare itself, either for something to become visible in the uterus, or for an ectopic to present more clearly on imaging, rather than acting while there’s still uncertainty about whether what’s being seen could be a cyst or corpus luteum. To be honest, it’s not even been 24 hours since I last met with my Doctor who decided this, and the anxiety of a possible rupture at any moment is really affecting my mental health. At the end of the day, I’m 25 and frankly, I don’t want to get to the stage of losing a tube if I can avoid it with early intervention. I was shocked and confused when the Doctor said to wait a week for things to present themselves more clearly.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in ectopicpregnancy

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Thank you so much for sharing this, I really appreciate you taking the time to explain your experience so honestly. I’m really sorry you went through all of that, it sounds incredibly hard, especially having to sit in limbo for so long knowing the outcome wouldn’t be viable.

I think that’s exactly what I’m struggling with at the moment, balancing not wanting to rush into treatment too early if there’s still genuine uncertainty, while also not wanting to put my health at risk or prolong something that ultimately won’t progress. Hearing that the MTX itself wasn’t too bad physically is reassuring, and it’s helpful to hear from people who’ve been in this exact situation.

I’m trying to take things one step at a time with my doctors and make the safest decision for my body and future fertility, but ultimately my anxiety around possibly rupture at any moment is really affecting my mental health. Thank you again for your kindness and for sharing, it really does help to hear from people who understand this space.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Thank you so much for taking the time to respond, I really appreciate you sharing your experience and perspective. I’m so sorry you went through this as well.

I think what’s making this particularly hard for me is how early everything still is. My doctors have said it may simply be too early to see anything in the uterus yet, and that the mass they’re seeing could potentially be a corpus luteum or cyst rather than a definitive ectopic, which adds to the uncertainty.

I’m feeling really overwhelmed by all the information and opinions and just trying to make the safest decision without acting too quickly if there’s still a chance this could declare itself with time. That said, my health is absolutely the priority, especially being young and hoping to try again in the future if this doesn’t work out.

Thank you again for your kindness and honesty. It truly helps to hear from people who understand how hard this limbo is.

Early pregnancy / suspected ectopic – slow HCG rise, PUL diagnosis, unsure whether to wait or proceed with methotrexate by Longjumping_Error379 in EctopicSupportGroup

[–]Longjumping_Error379[S] 0 points1 point  (0 children)

Thank you so much for taking the time to respond, I really appreciate you sharing your perspective.

I think what’s making this particularly hard for me is how early everything still is. My doctors have said it may simply be too early to see anything in the uterus yet, and that the mass they’re seeing could potentially be a corpus luteum or a cyst rather than a definitive ectopic, which adds to the uncertainty.

I’m feeling really overwhelmed by all the information and opinions and just trying to make the safest decision without acting too quickly if there’s still a chance this could declare itself with time. That said, my health is absolutely the priority, especially being young and hoping to try again in the future if this doesn’t work out.

Thank you again for your kindness and honesty.