# Ectopic - Surgery vs Methotrexate



## 2016

I am currently struggling with a second ectopic in my right tube :cry: (first one was 7 months ago and they saved the tube).

My hcg has risen from 200 on Saturday to 330 yesterday and they have told be to decide whether I want the methotrexate shot or surgery. As I only have discomfort and no major pain I have a day or so to decide and I would really appreciate your help. :flower:

As I see it, the *pro's for Methotrexate* are:

- my tube gets saved
- no surgery
- can have it a few days sooner than I would get in for surgery

*con's for Methotrexate:*

- one dose might not be enough
- 3 month wait to TTC if 1 dose, 6 months wait if 2 doses
- might end up in surgery anyway if it doesn't work
- has side effects including weakening the immune system
- what is the point of leaving the tube there if its already caused ectopic twice?

*pro's for Surgery *are:

- I have recovered well from this type of surgery twice before (one for gallbladder and then the last ectopic)
- The affected tube will be removed and so can't cause me another problem.

*con's for Surgery*:

- It hurts! (gotta love the morphine though)
- General anesthetic wipes out your body and it takes ages to get fit again.
- NHS will be rooting around in my lady bits and I don't trust them!
- The "good" tube might not be good at all and I might be reducing my chances of success even further.

That's all I can think of for now :shrug:

What did you have and what would you recommend?


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## africaqueen

I am sorry to hear u are going through this again sweetie :-(
Personally i think surgery is the best option with tubal removal as this is your 2nd ectopic i would say if that tube is left, you will have even more scar tissue and run a much higher risk of future ectopic :-( i had my left tube removed in jan and my right tube seemed to be healthy so i am glad my tube was taken as it was too damaged and i have a good chance of normal pregnancy now i have 1 healthy tube. I was lucky really as i found the pain after my surgery was minimal and i recovered quickly from the general. The decision has to be made by you, but if it were me, i would want the tube gone. twice is more than enough to endure this... Im here if u want to talk xxx


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## Martine31

I had my tube removed. At the time I was hell bent on getting rid of in in case it happened again, the thought of which was too horrible to think about at the time. I assumed (wrongly) that the tube was damaged, hence wanting rid, I later found out that it was just long and the egg hadnt made it out in time.

I think now I would have the shot, although again at the time the thought of waiting three months was a put off.

I probably am not helping, but I wish you the best of lcuk with your decision. XXX


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## africaqueen

Just wanted to add- the recommended time to wait to ttc again after surgery is also 3mths as they like you to heal up to prevent scar tissue causing probs and also that u are emotionally ready and my 3mths is almost up and it went soooo fast ;-)

xxx


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## fluffyblue

Hey hun ive come out of hiding to reply to this, I had an ectopic in November and took methotrexate with HCG levels as low as yours and also the same percentage of rise.

I personally would go with the shot as you can always ask fertility etc to do you a HSG after the three months to check the scarring etc of your tube. It can help with diagnosis of whats happening. Just because you have had a 2nd ectopic doesnt mean your tube is knackered !

I am scared stiff of another ectopic but am prepared to take the risk. 

Hope you work it out babe xxxxx


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## Martine31

Yes I echo what fluffyblue says about just because you have had a ectopic doenst mean the tube is knackered. My hospital was all set to take my other one away having declared it "useless"- their words. 11 weeks before surgery I found out I was pregnant!

Very best of luck, I know what a difficult time it is. XX


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## KimmyB

So sorry you're going through this again :hugs: I can only speak from experience and am not going against anything that the other ladies have said - it's all great advice from some brave ladies. I had the methotrexate as I too wanted to avoid surgery. My numbers were low and they said the chances of the methotrexate failing were low (this is true by the way). So I had the shot. Unfortunately it didn't work and 10 days later I was rushed to theatre with a ruptured left tube. So for me I would recommend surgery as you have had 2 in the same tube. I had 10 days of almost unbearable pain from the methotrexate but I thought that was it working - how wrong was I! Have the doctors swayed in favour of anything? Ultimately it is your decision hun but I am here if you want to PM me x


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## 2016

KimmyB said:


> So sorry you're going through this again :hugs: I can only speak from experience and am not going against anything that the other ladies have said - it's all great advice from some brave ladies. I had the methotrexate as I too wanted to avoid surgery. My numbers were low and they said the chances of the methotrexate failing were low (this is true by the way). So I had the shot. Unfortunately it didn't work and 10 days later I was rushed to theatre with a ruptured left tube. So for me I would recommend surgery as you have had 2 in the same tube. I had 10 days of almost unbearable pain from the methotrexate but I thought that was it working - how wrong was I! Have the doctors swayed in favour of anything? Ultimately it is your decision hun but I am here if you want to PM me x

That is a big fear of mine. I just know I am that unlucky sort of person who will end up with 2 metho shots and STILL surgery! :nope:
The thought of shutting down my immune system with the metho then ending up in an NHS hospital makes me *shudder*.

Is it really a 3 month wait to try after surgery? I was told with my last op 6-8 weeks and that was only so long because they left the tube :shrug:


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## africaqueen

yes my consultant said to wait 3mths to try again even after removal of the tube as he said not all ectopics are tubal, some rare cases the embryo can attach to scar tissue in the surrounding area. 3mths went really fast and now i knw when we ttc again in 2wks, that i have let my body and mind heal and there is much less chance of a 2nd ectopic 

But then i have been ttc for over 5yrs in total so 3mths didnt seem so bad to me. 

Good luck with whatever you decide hun xxx


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## KimmyB

I understand your fear. There is another lady on here - she's called Amy and her nickname is Puppymom (she's on my friends list) She had 2 ectopics in the same tube and ended up having the tube removed for fear of another ectopic due to extra scar tissue (I think that's the right story). Perhaps you could talk to her and get her perspective? Afterall she was in the same boat as you and she is a lovely lady. Again I am so sorry you're going through this again, I know the pain of one ectopic so 2 must be just unbearable :hugs: x


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## tinybutterfly

i'd get surgery, but not to have my tube removed, just little one.
my friend had it done before, their little one had implanted on her ovary itself and
they managed to save everything.
she just had to wait for AF and then they could start trying again, she was preggers 2 months later.

personally i didn't have to choose for my ectopic as i miscarried naturally from it (there's odd, odder and then there's me, yep)


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## 2016

The first surgery I had they saved my tube but that is not an option this time. They have made me wait and wait hoping it would end naturally, but no luck.


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## tinybutterfly

oh, it's not a matter of them "not wanting", i thought it was that, my bad

then i would do what your body recovers fastest from, which is probably the surgery.
with the methotrexate you're out for at least 3 months, with surgery i think you'll be healed quicker


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## NatoPMT

Hi 2016 - have you had your meeting with the fertility expert yet? How did you get on?


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## 2016

Just about to go in and see her now :thumbup:


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## Monsterpops

Hi - sorry to stick my nose in, but i'd opt to keep the tube whatever, I lost my first tube due to an endometrial cyst and have since had an ectopic in my only tube, if they had taken that it would've been game over - although am still ttc 3 years on, u never know wen a damaged tube mite come in handy lol, sometimes its all u've got x


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## africaqueen

tinybutterfly said:


> oh, it's not a matter of them "not wanting", i thought it was that, my bad
> 
> then i would do what your body recovers fastest from, which is probably the surgery.
> with the methotrexate you're out for at least 3 months, with surgery i think you'll be healed quicker

I had my entire left tube removed and i still had to wait 3mths before ttc again so u heal no quicker through having surgery. being "out" for 3mths is not a bad thing though as during that time your body and mind are healing ready to deal with a new pregnancy and 3mths goes fast ;-)

2016- hope it goes well as can be expected for you today and il be looking for a update. xxx


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## 2016

SURGERY! :cry:

Met the lovely new FS today. What a keeper! :happydance:

Anyway, she was quite clear in her opinion that surgery is my best option. She said that tube is obviously damaged and will almost certainly cause me a problem and risk my life again. My chances are much better if I just let my body figure out how to use my left tube to collect from both ovaries.
She is also going to discuss with the surgeon to arrange that they do a dye test on my left tube during surgery to kill two birds with one stone. :thumbup:

If my left tube is open she will still do investigations for luteal phase defect/low progesterone to give me the best chance possible. If it is blocked, I will be on the list for 3 free cycles of IVF on the NHS :yipee: I told her I thought it had to be 2-3 years of trying before that but she said if you don't have any working tubes you don't have to wait.

Oh well, neither way was going to be a walk in the park but she reckons I will be up and trying again sooner after surgery (as soon as I feel well enough apparently).

Thanks for all your ideas/advice and support. x


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## debgreasby

That's great news hunni xxx


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## tinybutterfly

surgery it is then!!!

ok, i don't understand something... if they say they're going to see if your one tube can
collect from both ovaries, does that mean they reposition one ovary or something?
i can't imagine your tube switching left-right-left-right all the time hehehe, so how does
that work exactly?

yay for free IVF if needed to be... but we hope not... right? or would you like IVF?
the thought crossed my mind tbh, i mean, we KNOW we can make kids, it's just a matter
of having a good egg and a good sperm meeting eachother...you know, kinda to push things along a bit


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## Martine31

africaqueen said:


> tinybutterfly said:
> 
> 
> oh, it's not a matter of them "not wanting", i thought it was that, my bad
> 
> then i would do what your body recovers fastest from, which is probably the surgery.
> with the methotrexate you're out for at least 3 months, with surgery i think you'll be healed quicker
> 
> I had my entire left tube removed and i still had to wait 3mths before ttc again so u heal no quicker through having surgery. being "out" for 3mths is not a bad thing though as during that time your body and mind are healing ready to deal with a new pregnancy and 3mths goes fast ;-)
> 
> 2016- hope it goes well as can be expected for you today and il be looking for a update. xxxClick to expand...

I agree with you, I was told I didnt have to wait but in reality its major abdo surgery and it took me 4 mths anyway to get back to normal ( as much as we were "trying" from about 7 weeks after).

You do need time to recover and you dont want another pregnancy stretching a post operative sit. I dont think surgery is the quick answer. 

Best of luck 2016. XXX


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## Martine31

Glad you have decided and you seem upbeat ( as upbeat as you can be in this situation)

Best of luck for surgery. XXX


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## puppymom32

So sorry babes in April of last year I had the same decision to make as I had my second ectopic 6 years apart. I chose the surgery too as I couldnt handle the heartache and pain that came with having another ectopic. 1 is more than anyone should have to deal with. I know it will be hard but there are so many wonderful success stories of ladies with one tube going on to have lovely babies. So glad they are gonna do the dye test while they are in there my dr did the same thing and said all was fine with my other tube. I am here if you ever need to talk about anything. Thinking of you.


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## puppymom32

tinybutterfly said:


> surgery it is then!!!
> 
> ok, i don't understand something... if they say they're going to see if your one tube can
> collect from both ovaries, does that mean they reposition one ovary or something?
> i can't imagine your tube switching left-right-left-right all the time hehehe, so how does
> that work exactly?
> 
> yay for free IVF if needed to be... but we hope not... right? or would you like IVF?
> the thought crossed my mind tbh, i mean, we KNOW we can make kids, it's just a matter
> of having a good egg and a good sperm meeting eachother...you know, kinda to push things along a bit


Tiny,
From what my dr has told me the tubes are like little jiggly straws and everything is all kinda mushed back there together anyways so it is very common for your tube to pick up the egg from the side that doesnt have a tube. It just kinda floats around back there waiting for an egg from either side. I guess it can kinda sense it when an egg is near. Crazy isnt it. 

2016 my dr and I discussed starting clomid again but I opted to try soy just to hopefully help me ovulate on my good side there are so many different options that dr will have.


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## 2016

I don't think surgery is the "quick" answer :rofl:
I had surgery 6 months ago and was walking round an aquarium (on painkillers mind you) 2 days layer. We were also back to BD 10 days later. Ok so they didn't remove the tube but they did remove a tennis ball sized ovarian cyst on the opposite side so it was pretty major. Also a year before that I had my gallbladder removed (which the FS said was comparitively more serious than having a tube removed...and I was back horseriding a week later.
All I know is I recover quite quickly from surgery and I am just hoping I do the same this time.

Tiny...yeah I was surprised to learn the tubes/ovaries aren't out to the sides lik in the pictures. Some women have been left with only one ovary on the opposite side to only one tube and still fall pg! And yes I would quite like IVF. Again, definitely not an "easy" option but I will be pushing for it asap if my left tube is defunct!

Puppy....I have heard so many people have success with clomid. I have taken soy a couple of cycles because I ovulate a bit late, but it never seemed to make any difference to my cycle. The docs have all said clomid is not my answer because I produce good follies and ov just fine.

So tired...going to bed. Hang in there body!


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## Martine31

Yes I am testament to clomid boosting the good side, plus as puppymom say the egg can travel over.

Thinking of you hun. XX


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## africaqueen

2016, i am glad they have sorted it out for you and i honestly believe surgery is the best option as u wnt live in fear of repeat ectopic as u would if that damaged tube remained. horrible and sad to go thru but pray u get a bfp soon and i think its great news about the tubal dye test and then 3 shots of ivf if any issues ;-) just means u have a backup plan should u try to conceive for longer than u want to. My dr said if we have not got pg within a yr, they will also offer us 3 shots of ivf for free too.
Just all helps to knw we have a great shot at being mummies ;-)

I hope the surgery goes well and u recover quickly. Thinking of you xxx


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## africaqueen

Martine31 said:


> Yes I am testament to clomid boosting the good side, plus as puppymom say the egg can travel over.
> 
> Thinking of you hun. XX

martine31- how many cycles of clomid did it take for you to get pg? i was on it a few yrs ago when my pcos was playing me up and i O'd on 50mg back then. Obviously my fertility improved as i got pg naturally but with only 1 tube want to give anything a shot if im not pg within 3-4mths time x


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## Martine31

I got pregnant 2nd cycle. I was ovulating but it was just to increase the chances of ov on good side. X


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## KimmyB

2016 I'm glad the decision has been made, atleast you have a concrete plan now and can move forward. I will be thinking of you hun x


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## tpmdl05

Hello. I would like to start by saying I am very sorry about this unfortunate situation. I too have had an ectopic pregnancy. I received two shots of methotrexate and still ending up having to have my left tube cut in half due to the fetus continuing to grow. I cant give you advice as to whether or not you should get the shot or surgery but.......

I will tell you to keep the faith and stay positive. I thought I would never be able to have children but I am pregnant and expecting in November!

I wish you the best of luck


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## Wobbles

I was faced with a simular situation only the option of methotrexate was AFTER the op because my levels still continued to rise! :( I refused it ..wasn't interested and my instinct was right my levels started dropping on their own.

Also I knew someone who lost their tube from an erupted ectopic and emergency operation, lost her tube and at the time had one child ...now has 3!

I see you have made a decision and Im not sure if theres an bigger updates but sending a little cyber huggle anyway.

Good luck 

x


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## 2016

Surgery will probably happen at 5pm today. Wish me luck!


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## africaqueen

Good luck hun. Will be thinking of u and wish u a speedy recovery xxx


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## NatoPMT

Im really glad you had such a useful meeting with a good consultant, thats great news, Im glad they have sorted the surgery so quickly too - now the decisions have been made you and know what you have to do. 

will be thinking of you later


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## debgreasby

Good luck hunni x


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## puppymom32

Good luck huni will be thinking of you.


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## KimmyB

Good luck hun x


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## Amos2009

My thoughts are with you today...xxx


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## 2016

Hormone levels in blood have dropped! They were hcg 356,progesterone 7 a few days ago...now hcg 136, progesterone 2.9!!!!!
Surgery cancelled (for now). Just going to have a scan to double check.
Can't believe it! Think the disgusting Chinese herbs and accu might have helped! :yipee:

Of course that does leave the question - what do I do with a dodgy right tube? The consultant said this ectopic would probably block the tube permanently so it hopefully won't cause more probs. I do worry though that my body always uses that tube and will continue to do so but the poor eggy will never meet the :spermy:.

Blinking heck my body is annoying! :grr:


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## puppymom32

Aww babes not sure maybe once your body gets all sorted out then they can do a lap just to see how damaged the tube is.


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## Amos2009

I agree with Amy. I wouldn't make any decisions until you know how good or bad the tube is. Right now I am wishing they had taken out my tube instead of repairing it, because I will always be paranoid about another baby getting stuck in there. I know if this pregnancy turns out to be ectopic, I will demand they take the tube out this time! Keep us updated hunni!


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## 2016

I am on my way home :wohoo:
Have been told to get bloods redone on Monday and, as soon as my hcg drops to 0 I can schedule a HSG to check what I'm left with.


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## puppymom32

Thats awesome news. Hope the numbers go down quickly so you can get some answers.


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## Amos2009

Great news! Hope they drop quickly!


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## africaqueen

Thats good news hun!

I hope the HSG shows up that the damaged tube is not going to cause u any probs and fyi- take some strong painkillers BEFORE your HSG ;-) i had one a few yrs ago and all i can say is ouch! painkillers would of deffo taken the edge off it. Good luck and hope all goes well for u xxx


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## KimmyB

Great news 2016 hun x


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## Martine31

2016 said:


> Hormone levels in blood have dropped! They were hcg 356,progesterone 7 a few days ago...now hcg 136, progesterone 2.9!!!!!
> Surgery cancelled (for now). Just going to have a scan to double check.
> Can't believe it! Think the disgusting Chinese herbs and accu might have helped! :yipee:
> 
> Of course that does leave the question - what do I do with a dodgy right tube? The consultant said this ectopic would probably block the tube permanently so it hopefully won't cause more probs. I do worry though that my body always uses that tube and will continue to do so but the poor eggy will never meet the :spermy:.
> 
> Blinking heck my body is annoying! :grr:

Great news about the surgery!

As I said earlier in this thread I had a tube removed due to ectopic and they were due to sterilise me due to the perceived risk of it happening again. I was booked for the surgery on 21 Jan 2010 and found out I was pregnant 11 weeks before this date.

I will never let them take my remaining tube, I will risk another ectopic! I also dont think they can assess the tube properly until its out. I would say hold on to what you have, and a hsg will maybe give a bigger insight ( or even give the tube a wee clear, so many people fall pregnant 1st cycle after an hsg)

I am delighted for you and think you have been very brave and strong. XXX


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## 2016

Had a wonderful weekend! Expected to be spending it glued to the sofa high on painkillers and instead I was making the most of feeling much much better. A few crampy twinges yesterday and no pain at all today :yipee: Also my test is looking very very faint. Never thought I would say this but I am so looking forward to a :bfn: and I am sooooo sick of peeing on sticks!!!
Got follow-up bloods tomorrow then will go about booking my HSG. :thumbup:

Thank you for all your ideas, advice and support which really helped get me through this horrible time :hugs:


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## Amos2009

So glad you had a wonderful weekend! Your PMA is really inspiring.


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## goddess25

I am so sorry this has happened again to you. I dont know if you know but Methotrexate is a chemotherapy drug which is used to treat cancer aswell.... i am a nurse and if it were me i would avoid any cytotoxic treatment as much as possible.. i dont know what the dose is in the shot for your cause but its a very very strong drug with many side effects.

At the end of the day you need to gather all the information about both and then make an informed choice that is right for you. Whatever decision you make will be the right one. Good Luck!


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## 2016

goddess25 said:


> I am so sorry this has happened again to you. I dont know if you know but Methotrexate is a chemotherapy drug which is used to treat cancer aswell.... i am a nurse and if it were me i would avoid any cytotoxic treatment as much as possible.. i dont know what the dose is in the shot for your cause but its a very very strong drug with many side effects.
> 
> At the end of the day you need to gather all the information about both and then make an informed choice that is right for you. Whatever decision you make will be the right one. Good Luck!

I have heard it's nasty stuff! That's why I am so glad I got away not having that or surgery. Hpt is almost negative today! :yipee:


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## africaqueen

Thats great news 2016! i am so glad it went as painlessly for you as possible(physically) i am sorry for your loss sweetie, but i am glad the outcome is as good as can be in this situation ;-) when are u having your HSG? xxx


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## 2016

africaqueen said:


> Thats great news 2016! i am so glad it went as painlessly for you as possible(physically) i am sorry for your loss sweetie, but i am glad the outcome is as good as can be in this situation ;-) when are u having your HSG? xxx

Thanks. Not sure when the HSG will be....I asked when I went and had my (hopefully last) bloods done just now. The doc said they would try schedule asap assuming my numbers are still dropping.


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## puppymom32

Great news hun!!!


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## goddess25

Thats fantastic news.


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