Questions
8 Replies
tanya1231 - June 21

I had methotrexate injections on 5-16 and 5-20 for a possible ectopic pregnancy.

Today 17dpo HcG is 381 and progesterone is 10.5.

Should I be concerned about the effects of the methotrexate on pregnancy?

Is the progesterone too low?

 

B. Jacobs, M. D. - June 22

Methotrexate will kill a pregnancy. That is why it is given to try to treat anectopic pregnancy, without surgery. Please discuss your question with your physician. It is possible that the methotrexate did not adequately treat your ectopic.
Good luck.

 

tanya1231 - June 22

I took the methotrexate on 5-16 and 5-20, on 5-22 I had my lmp. On 5-31 my beta was ZERO! On 6-5 I ovulated and now my beta is 381 and progesterone is 10.5. This is a NEW pregnancy. I had the methotrexate 16 days prior to this ovulation...will that effect THIS fetus? Is that progesterone too low?

 

B. Jacobs, M. D. - June 23

I expect the methotrexate to be gone, by now, but I do not actually reacll the half life of that drug in the body. During pregnancy, I like to see the progesterone level at least 20 ng/ml. Thre are a numberf of possible explanations. One is that you need more progesterone.
Good luck.

 

tanya1231 - June 23

The half life of methotrexate is 8-15 hours, I am worried about the depletion of folic acid. I started taking folic acid 88mcg on 5-31 when my beta returned to zero. What do you think?

 

tanya1231 - June 23

Also...todays beta is 718, it was drawn 44 hours later.

 

B. Jacobs, M. D. - June 24

We want to see the hCG level at least double in 48 hours. Yours did. That is very encouraging. I do not, off the top of my head, remember enough about fo;ic acid metabolism to have adequate information to tell you about you folic acid levels, at the time of conception and embryo developement with this pregnancy. We do know that women who have low folic acid levels are at greater risk for certain birth defects. I think your starting adequate folic acid supplement when you did will probably be protective.
Good luck.

 

tanya1231 - June 26

Okay...
My betas...
Sunday 381 progesterone 10.5
Tuesday 718 progesterone 16
Thursday 1908 progesterone 8.9 (I am taking Prometrium 100mg vaginally twice a day)

I went to the OB/GYN yesterday and saw an early gestational sac. I am worried about the progesterone level but she said that the levels fluctuate a great deal and that since I am taking it vaginally that the level is higher where I need it at and that she is not at all worried about it. She said not to check anymore levels and to try to relax until I go back next Wednesday and that hopefully the next week we will see a heartbeat. What do you think...should I worry?

 

B. Jacobs, M. D. - June 26

The progesterone you are putting in your vagina produces a good tissue level in the uterus, without producing much of a blood level. I would not be concerned about the blood level if you are using adequate vaginal progesterone.

 

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