Ectopic - Surgery vs Methotrexate

[2016]

I am currently struggling with a second ectopic in my right tube (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.

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

What did you have and what would you recommend?

 

[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

 

[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

 

[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

 

[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

 

[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

 

[KimmyB]

So sorry you're going through this again 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

 

[2016]

So sorry you're going through this again 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!
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

 

[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

 

[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 x

 

[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)

 

[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.

 

[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

 

[NatoPMT]

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

 

[2016]

Just about to go in and see her now

 

[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

 

[africaqueen]

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

 

[2016]

SURGERY!

Met the lovely new FS today. What a keeper!

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.

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 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

 

[debgreasby]

That's great news hunni xxx

 

[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