HCG levels after Methotrexate
I’m hoping to hear from others who’ve had methotrexate for ectopic pregnancy, especially with slow hCG decline or a possible plateau after day 7.
Day 1 of cycle: last normal period
Started spotting since day 27 after my last period, which I assumed was implantation bleeding. Home pregnancy test positive.
Day 34: hCG test 74
Day 36: light bleeding (bright pink, filled a daily pad)
My doctor recommended serial hCG testing and an ultrasound. The ultrasound did not show anything, but my uterine lining was 18 mm. Doctor said it was too early (~5 weeks)
Day 37: 114
Heavy bleeding on day 38, shed uterus lining too.
Day 39: 66
Day 41: 76
Day 43: 116** **
Day 45: 154
At this point my doctor suspected ectopic pregnancy, and ordered another ultrasound which was inconclusive again. My uterine lining was back to 4 mm.
Day 47: I received methotrexate (MTX) (this is Day 0 of treatment)
Day 4 post MTX: hCG 200
Day 7: hCG 170
Day 10: developed sharp one-sided pelvic pain and heavy bleeding. Got worse by day 11.
Day 11: ER visit, hCG 128, another ultrasound which showed nothing again. Bleeding subsided. After doctors confirmed that I did not rupture, I was sent back home.
Day 14: hCG 124
My doctor said that since day 14 is 27% lower than day 7, things look okay.
I am not convinced since there is no significant drop between day 11 and day 14, and I am still in pain. Not the worst pain, but enough to freak me out.
Has anyone had hCG stall around this range before eventually going to zero without another MTX dose?
I am worried because the last time I had a drop and a plateau, it was followed by an increase.