PUL / Ectopic low but fluctuating HCG
Hello
I am currently dealing with a PUL. I have referenced below my hcg which after consecutively reducing, it’s sadly increased today. At the same time, when I had my ultrasound, they said the tube has possibly expelled the pregnancy tissue as there is now an adnexal mass of 1.9x2.1 which wasn’t there before. There was some free fluid but not much. I had pain last night and went to ED but as it was not ‘acute’ they sent me home and today went back for the scan. My pain was mild and in my groin area last night.
I am 38 with low AMH and high FSH and have been ttc for 20 months. I was waiting to start ivf when I conceived but it’s resulted in this PUL.
I have a history of endometriosis and have had two laparoscopic surgeries. The last removed adhesions from my ovaries. Probably contributes to my low amh.
Frustratingly, my left tube seemed blocked at a hyfosy last year and today, it was my right tube that had the adnexal mass. Which they couldn’t tell whether attached to ovary or tube or both.
I’ve been scheduled for bloods again on 09/08 and my next scan is 10/08. I really don’t want to take methotrexate due to not being able to TTC afterwards, plus a potential negative side effect with people who already have diminished reserve. But also, the surgery option does not seem favourable as my ovaries are already low on follicle count and I may end up having both tubes removed as left one there’s no spill and right one is the one with the mass! Feel concerned if I take methotrexate I may be in this predicament again in the future with damaged tubes. So many unknowns! :(
Sorry, long winded, but what I’m asking is if anyone has been diagnosed with a PUL that has resolved itself even when the hcg levels have increased. Or has anyone experienced a tube expelling the pregnancy tissue?
Thanks you and so sorry to anyone who is going through or has been on this awful journey.
Positive pregnancy test 08/07
09/07 hcg 80
11/07 hcg 210
13/07 hcg 98
23/07 hcg 93
28/07 hcg 153
30/07 hcg 134
03/08 hcg 96
06/08 hcg 68
07/08 hcg 91
Started bleeding black 17/07
Full bleeding 20/07 for 4 days
Still bleeding/spotting black 07/08