I’m currently around 6 weeks pregnant (last period April 6). I’ve had brown spotting since May 8, which is still continuing. I also had a transvaginal ultrasound today and the doctor said they could not see a gestational sac in the uterus.

I have a history of 4 previous miscarriages, so I’m very anxious right now. I also have mild cramps, but they don’t feel one-sided. I don’t have shoulder pain or severe pain.

The doctor told me to go to the ER if I notice heavy bleeding, shoulder pain, or one-sided severe abdominal pain, mentioning ectopic warning signs. That has made me even more worried.

I had my hCG blood test done today and am waiting for the results.

My question is — is it possible this could still be ectopic even if nothing was seen on the scan? What could be the possible next steps in evaluation or management in this situation?

Got my HSG yesterday - left tube is blocked but not dilated. waiting for them the get my results over to my OB but at the fertility clinic they said it’s unlikely I’ll have to get it removed. But my question is wouldn’t that cause risk for an ectopic? Isn’t it just better to get the blocked tube removed? Has anyone TTC with one blocked tube and one normal tube and had a good outcome?

I've been answering questions in these communities for a long time, and there are a handful of things that come up over and over that I really wish people knew before they were sitting in a waiting room being told not to worry.

So here it is, all in one place. I'll probably edit as I re-read and think of things to clarify or add.

1. The “discriminatory zone” does not mean what many people think it means

The discriminatory zone — usually cited as 1,000–2,000 mIU/mL, sometimes higher — is the hCG level above which an intrauterine pregnancy should generally be visible on transvaginal ultrasound.

That’s it. That’s all it means.

The AAFP guideline on ectopic pregnancy explicitly defines it this way: “The discriminatory level is the β-hCG level above which an intrauterine pregnancy is expected to be seen on transvaginal ultrasonography.”

Not ectopic pregnancy. Intrauterine pregnancy.

If you're told an ultrasound is completely useless below 1,000 hCG, that’s an oversimplification and can be misleading in the context of ectopic pregnancy. An ultrasound at low hCG can still provide important information when ectopic is on the differential.

2. Ectopics can absolutely be seen at very low hCG. Here's why

When looking for an intrauterine pregnancy, you're trying to see a tiny gestational sac growing inside the uterus. That does require some hCG-driven growth.

But with an ectopic, you're often not looking for the embryo itself. You're looking for what the pregnancy is doing to the surrounding tissue.

A 2014 Harvard/Brigham and Women’s study of 231 confirmed ectopic pregnancies found:

• Tubal rings were seen with hCG as low as
• Adnexal masses were seen with hCG as low as 7

The authors concluded there is “no lower hCG cutoff value” for visualizing ectopic pregnancy findings.

Why? Because even at very low hCG, an ectopic can cause:

• A tubal ring — the tube swells and deforms around the implantation site
• A hemorrhagic or complex adnexal mass — bleeding into the tube creates a visible mass even when the embryo is microscopic
• Free fluid in the cul-de-sac — even a small amount of tubal bleeding can pool and be seen
• Disruption of normal adnexal architecture — the tube just looks wrong

The tube is a very small, tight space. It doesn’t take much to make things look abnormal.

Importantly, the most common finding in that study was not an embryo or yolk sac — it was a nonspecific adnexal mass. Just the tube looking wrong.

That has nothing to do with hCG reaching a certain threshold.

3. Not seeing an ectopic on ultrasound does NOT rule one out

This is equally important.

Even at high hCG levels, many ectopics are never visualized.

A normal or nondiagnostic ultrasound does not mean you do not have an ectopic. It means they didn’t see one. Those are not the same thing.

4. Rising hCG does NOT rule out ectopic

Ectopics very commonly rise slowly. Some rise at normal rates.

Rising hCG does not mean intrauterine, and it does not mean you're safe.

And here’s something that I think is underappreciated: reproductive endocrinologists and early pregnancy specialists do sometimes see ectopics that start with slow or abnormal rises and later begin doubling more normally.

A lot of our published ectopic beta-pattern data comes from ruptured ectopics — patients who often never had very early monitoring before things went wrong. The pre-rupture picture is genuinely understudied.

That doesn’t replace evidence-based medicine, but it does highlight the limits of the data we currently have.

So the fact that your betas “look better now” is not always reassuring if there is still no confirmed intrauterine pregnancy and the overall picture remains concerning.

5. hCG patterns — what they mean and what they don't

People get told things like "your hCG is low" or "your hCG looks good" all the time. A single number in isolation often doesn't tell you very much.

The trend matters.

What a normal rise can look like in a viable intrauterine pregnancy

Research suggests that among viable intrauterine pregnancies:

• With a starting hCG under 1,500, about 99% will rise at least 49% over 48 hours
• Between 1,500–3,000, at least a 40% rise over 48 hours is expected
• Above 3,000, at least 33% over 48 hours is expected
• Above 6,000, rates are much slower and vary widely

As hCG gets higher, the rate naturally slows.

A rise slower than these thresholds raises concern for ectopic pregnancy or early pregnancy loss, though rare viable pregnancies can fall outside these patterns.

What a drop means

• A drop of at least 21% over 48 hours suggests a likely failing intrauterine pregnancy
• A drop smaller than that raises more concern for persistent PUL or ectopic because the pregnancy may not be resolving the way we'd expect
• A drop followed by a rise is one of the biggest ectopic red flags

What a plateau means

Plateauing hCG is not inherently reassuring. It needs close follow-up and should not automatically be assumed to represent a resolving miscarriage.

What "slow then normal" can mean

As discussed earlier, some ectopics appear to start with slow, below-cutoff rises and later normalize. This pattern is understudied.

One concern is that many patients never have very early betas drawn. If someone only starts monitoring later — after the pregnancy has already begun growing more actively — the numbers may simply look "normal" from the first beta onward. You would never know there had been an earlier abnormal pattern.

But if you do happen to catch a pregnancy showing slow or concerning rises early, and then later see those rises begin looking more typical, that shouldn't automatically be treated as reassuring. The fact that the numbers improved does not erase the earlier abnormal behavior.

This doesn't mean every "slow then normal" pattern is ectopic. It means the whole story matters. Earlier concerning trends should still be considered alongside symptoms, ultrasound findings, and whether an intrauterine pregnancy has actually been confirmed.

How often should you be getting betas?

It depends on the situation, but if there are still unanswered questions — abnormal trends, symptoms, or no confirmed intrauterine pregnancy — serial betas every ~48 hours is a very common approach.

One thing I see a lot is people getting moved to much longer intervals while they're still in a PUL. Sometimes it's because the numbers are rising more appropriately, sometimes because they're dropping, and sometimes simply because things seem to be "heading in the right direction."

But if the diagnosis is still uncertain and ectopic is still on the table, longer gaps can create a false sense of reassurance.

Betas can change direction. A pregnancy that initially appears to be resolving can behave differently later. And ectopics can rupture at any hCG level — including while numbers are falling.

The point isn't that every person needs bloodwork every 48 hours forever. The point is that if you still don't know where the pregnancy is located, there should be a clear reason for spacing testing further apart.

If you're in active monitoring for a PUL and ectopic hasn't been reasonably excluded, make sure you understand exactly why the monitoring interval is what it is — and if it's extending beyond ~72 hours early on, ask questions and push for an explanation.

6. Ectopic is NOT truly ruled out until there is a confirmed gestational sac with a yolk sac in the uterus

A thickened endometrium does not rule out ectopic.

A gestational sac alone does not fully rule out ectopic either, because pseudosacs can mimic one.

The pregnancy is not confidently confirmed intrauterine until there is a gestational sac with a yolk sac clearly visualized inside the uterine cavity.

Until then, ectopic generally should remain on the table.

7. Red flags that should escalate your care

• hCG that dropped and then rose again
• Bleeding that seemed like a period, followed by a positive during or shortly after
• A faint positive, heavy bleeding, then darkening tests

• an “early” positive; too early or too dark to truly be from the cycle you think it is, meaning you had a bleed you counted as a period

• Slow/low betas that later begin rising more normally
• Late first positives for cycle timing
• Ongoing spotting or bleeding with no confirmed IUP
• One-sided pain
• Shoulder tip or shoulder blade pain
• Dizziness or faintness
• Prior ectopic, prior pelvic surgery, prior PID, or IUD pregnancy — your risk is elevated and you deserve earlier and more aggressive evaluation
• IVF pregnancy — ectopic rates are higher with IVF than with natural conception, even when embryos are transferred directly into the uterus. Many people don't know this and assume a transferred embryo can't end up elsewhere. It can. IVF patients with abnormal betas or no confirmed IUP need the same vigilance as anyone else

If you have concerning symptoms plus a pregnancy of unknown location and are simply being told to wait, push for a clear follow-up plan and seek another opinion if necessary.

8. “PUL” is not a diagnosis

Pregnancy of unknown location (PUL) means they have not yet identified where the pregnancy is.

That’s all it means.

It does not mean you’re fine. It does not mean ectopic has been ruled out. It means the location is still unknown.

PUL should involve active follow-up:

• serial betas
• repeat imaging
• a clear plan for what happens next depending on your numbers and symptoms

It’s a temporary state, not a final answer.

9. That “cyst” might not actually be a cyst

Early ectopics are very commonly mistaken for hemorrhagic cysts or nonspecific adnexal cysts.

If your ultrasound mentions:

• corpus luteum cyst
• hemorrhagic cyst
• adnexal cyst/mass

...and you ALSO have:

• abnormal betas
• no confirmed IUP
• one-sided pain
• bleeding
• late positives
• other ectopic red flags

...do not let the word “cyst” automatically reassure you.

The clinical picture matters just as much as the ultrasound label.

10. D&C with pathology is an under-discussed diagnostic option

In some PUL cases where a viable pregnancy can reasonably be excluded, uterine aspiration/D&C with pathology can provide very useful information.

If chorionic villi are found, the pregnancy was intrauterine.

If they are not, ectopic becomes much more likely and treatment can proceed more confidently.

This option is not discussed nearly enough. (I had this done!)

11. MTX saves lives — but the diagnosis matters

Methotrexate is an effective and important treatment for ectopic pregnancy. In many cases it prevents surgery and preserves fertility.

The issue is not MTX itself.

The issue is making sure the diagnosis is reasonably solid before giving it.

A resolving chemical pregnancy does not need MTX. A true ectopic may.

Before treatment, you ideally want reasonable confidence that:

• the hCG trend supports ectopic over resolving miscarriage
• viable IUP has been reasonably excluded
• you understand follow-up and treatment-failure signs

Once those boxes are checked, MTX may absolutely be the right next step.

12. The data on early ectopics is incomplete — and that matters

A lot of what we know about ectopic beta patterns comes from patients who ruptured.

Many never had early monitoring before things became emergent.

That means the earliest, most treatable stages of ectopic pregnancy are likely underrepresented in the literature.

This is part of why one “reassuring” number or one “good” rise shouldn’t automatically override an otherwise concerning clinical picture.

13. Ectopics can rupture at any hCG level

Including very low ones.

A low hCG does not guarantee safety or extra time. Neither does dropping so track to negative.

14. Not all ectopics are tubal

Most are tubal, but some implant elsewhere — and these are often more dangerous and easier to miss.

Interstitial/cornual ectopics, in particular, can grow larger before rupture because they are partially surrounded by uterine muscle. When they rupture, bleeding can be catastrophic.

If your report mentions:

• eccentric sac
• cornual
• interstitial
• angular

...ask specifically whether the location has been fully evaluated and whether expert review is needed.

15. Life after ectopic

Many people go on to have healthy pregnancies after ectopic — including with one tube.

Things I’d strongly recommend after resolution:

• Early monitoring in future pregnancies
  • Serial betas
  • Early ultrasound
• Discussing an HSG with your doctor
• Starting folate again once hCG is negative

You should not be waiting until 8 weeks for reassurance after a prior ectopic.

-----
And finally:

If you’re reading this because you’re scared and in limbo right now, you are your own best advocate.

Ask for serial betas.
Ask for imaging even at low hCG.
Ask what specifically would change management.
Ask what would be required to confidently rule ectopic out.

And if the answers don’t make sense to you, seek another opinion.

A possible ectopic should be treated seriously until it’s confidently ruled out.

I have an IUD, but i know theyre not always foolproof, my mom got pregnant with one in. I can still feel the strings, but they feel slightly further down than before. i know that my partner did yk in me a few weeks ago. my breasts are past tender, they HURT, and ive been having cramps. last week one small singular blood clot came out when i peed. my periods usually around the 25th of the month. i dont like bell peppers, but i ate four of them like apples last week. i took two tests and both were immediately negative, but it couldve been too early. pregnancy with an iud is usually ectopic, and im fucking terrified right now, i know how dangerous that is. i dont have health insurance until the 1st. and if i am having a regular pregnancy, i cant right now. i cant do it. we just broke up because hes enlisting soon and if tell him it'll sound like im making something up to get him back. i dont know what to do, im really hoping that im just overthinking it and causing my own symptoms somehow. my family wont be supportive at all. what do i do??

I had an ectopic back in October 25, waited the 3 months as advised and then started ttc like crazy with no luck until this most recent cycle me and my partner decided to not try as we had a lot going on and it was going to be a very stressful time so we wanted to relieve a bit by taking baby stress off the table for a bit. As if by magic I missed my period, took a test and I’m so over the moon to be pregnant again. I have just under 2 weeks till my early scan to make sure everything is where it should be and my anxiety is through the roof. I know nothing I did caused my last ectopic but I can’t help but think everything I do now could ruin this. I’m so scared to have sex, go for a run, walk past somebody who is smoking or just to do about anything. I know it’s completely ridiculous but has anybody else felt this level of anxiety. days are feeling like weeks right now!

Just looking to vent because I honestly feel like I haven’t fully processed any of this yet and don’t really have anyone to talk to about it.

I had my first baby this past October. Pregnancy was brutal. I gained 80 lbs, ended up needing a C-section, and recovery was really hard. We live across the country from family, so it’s just been my husband and me trying to survive newborn life on our own. I started walking 12-20 miles a week around 3 months postpartum because I was desperate to feel like myself again and lose the weight. I saw changes at first, then my weight completely plateaued all through March no matter how hard I was trying. I was so hard on myself and blamed breastfeeding, hormones, lack of sleep, everything.

I was using Oura + Natural Cycles and was shocked my period came back around 3 months postpartum. We weren’t really using protection besides pullout. One stupid drunken night at the end of February we didn’t do that, so I assume that’s when I got pregnant, but honestly now I don’t even know what bleeding was a real period vs ectopic pregnancy bleeding.

Timeline:
October 16: my son was born

January 16: had protected sex

January 18: had protected sex

January 22: got my first period postpartum

January 30: had protected sex

February 7: spotted for 3 days

February 13: had protected sex

February 20: had unprotected sex

February 28: got my second “period”

March 25: got my third “period”

April 7: bled again for 4 days

April 18: bleeding started again

April 21: horrifying cramps started that night. Woke up at 2 AM in the worst pain of my life.

April 22: OB found 9 cm of blood pooled internally, pregnancy test was positive, but there was no pregnancy in my uterus. I was rushed into emergency surgery for an ectopic pregnancy and lost my left fallopian tube.

Looking back now, I realize so many things suddenly make sense. The weight plateau, the random bleeding, the severe hip pain I was having for weeks before surgery…all of it.

I think I’m struggling because my brain still can’t process that I was pregnant again while taking care of a newborn, and that it almost became life-threatening without me realizing it. I also feel really down for not “catching” it sooner even though I know logically I couldn’t have known.

If anyone has gone through something similar postpartum, especially with confusing bleeding or an ectopic after getting what seemed like regular periods again, I’d really appreciate hearing from you. I just feel really alone in this right now. It was all just so much to hear and happen at once.

Long read, sorry. I’m pretty out of it and feel like releasing this jumbled up set of emotions into the world.

My husband and I actively tried for about a decade before pretty much giving up a few years ago on the idea that it was possible for me to get pregnant. I had one very faint positive last year but each day after was negative so idk if it was a fluke or not.

I do not get regular periods on my own. I take provera to start a period every month, to ever three months, to avoid cancer and stuff.

This year, however, I had a natural period in fabruary and March. And another one started, on time, in April. But it didn’t end. I bled from April 13th until today.

Long periods aren’t new for me. I have PCOS. My periods have always been irregular. Longest one was 45ish days of bleeding(was able to stop that one with provera).

However, while a long period is normal, the cramping changed. It felt super odd to me, like I felt full and pressure and sometimes like I had to poop. I had sharp pain in my vagina and rectum a couple times too. It actually felt like what I imagined a small real contraction to feel like.

So, yesterday, even though my period started on time, the odd cramping on top of extended bleeding led me to take home pregnancy tests. All were very clearly positive.

Panic set in and I called OBGYN’s office who said to go to the emergency room. I did right away. Bloodwork hcg was around 9100 mIU. I was in shock. Literally looked at my husband and was like “WHAT THE FUCK” in a total daze. Cried a lot but was mostly numb because I knew this was not going to be a happy story for us.

They immediately got me in for a topical ultrasound and vaginal ultrasound. They didn’t find it in my uterus or anywhere else. Dx me with “Pregnancy of Unknown Location” which I learned from these groups last night is aka PUL.

I was really worried, but the dr that was attending to me called my obgyn to see what she wanted me to to, and my obgyn said she wanted me to get bloodwork two days later to see if my numbers go up or down and go from there. A “wait and see” situation. Honestly didn’t sit right with me just going home to wait it out, but I had no idea how to navigate any of it, so that’s what I did. Had the same steady cramps and a fullness. Read the Reddit posts in this and other groups until like 3 am though. Worried me but I tried not to panic.

Next day (today) had same cramps. bleeding picked up slightly but didn’t fill pads as described on my discharge papers as cause to go back to ER. The dr told me before I left the ER to go back if pain worsened, bleeding filled pads quickly, right shoulder pain, uncontrollable intense pain, pain on one side, or even if I just felt like a shoulder, etc.

Then I got a few seconds of a sharp pain on left side. Not too terrible. I’m used to the pain in my ovaries from pcos. It felt similar to a cyst - maybe a slightly worse. I felt dumb going back to the ER but I read all these stories on Reddit about ectopic pregnancies and rupturing and noped myself out of bed and into the shower. Messaged my husband, and he left work to come get me and take me to the hospital.

They got my blood work right away. Hcg rose to 10,250. They did the ultrasound again, but this time I asked the tech to press as hard as she could to clearly see as much as she possibly could. Right side didn’t hurt when she pressed. Left side hurt pretty damn bad ngl. I was vocal about it but thanked her for doing as I asked. I wanted the images to pick up as much as possible. I don’t think she was pressing crazy hard, but as hard as her training would allow. The pain was probably so intense because that was ectopic side. When we were done, she said she think she got more than they got the day before! She was awesome, and she was correct that she did.

Dr came when results were back and told me it was ectopic and visible in the ultrasound (thank you to that tech for pressing harder! They couldn’t see anything in that tube the day before). She said that my hcg is too high for methotrexate and I’d need surgery. Surgeon came in and went over options again but included methotrexate as an option but said if it didn’t work I could still rupture, so the safest option was to do the surgery and they said they would probably remove the whole tube.

I was pretty scared, but the surgery went fast. My care team was super kind throughout. The OR care team was incredible. So thankful for them. The chill meds kicked in and my anxiety went away. They put a mask on me and I was talking about the OR lights and that’s all I remember last lol. Woke up in the recovery room. The surgeon came in and said everything went fine. Ovaries look good and right tube looks good. They did remove left tube.

I went home a bit after surgery. It doesn’t hurt as bad as I thought it would but I’m sure I still have some of the IV meds they gave me in my system so we will see when it wears off.

They gave me meds for pain, but I have only taken the ibuprofen so far. Did you guys end up needing the actual pain medicine or was ibuprofen enough?

I’m probably going to cry a lot when this all sinks in more. Idk still feeling numb, emotionally. If you read all this, thanks for letting me vent to you.

ETA: I follow up in two weeks. If my hcg doesn’t go down, they said I may still have to take methotrexate, which sucks so I hope it goes down on its own.

Also, I mean to say “or if I just felt like I should” not “if I just felt like a shoulder” haha

I recently had what I thought was a miscarriage but during monitoring my hcg wasn't falling as normal and actually started to rise. I was estimated to be about 6 weeks pregnant at the time. My HCG levels went from 54 to 35 to 31 to 70 to 74 all about three days apart. I hadn't been pregnant long enough to have an OBGYN, so my primary care doctor was managing the miscarriage but referred me to an OBGYN once my levels started to rise. He acted somewhat annoyed that I was there but agreed to a couple more blood draws. Just curious if anyone has been through anything similar. I had booked a cruise before learning I was pregnant and am supposed to leave in a week. Trying to decide if I should prepare to cancel my trip. The doctor didn't really give me an answer yet. I'm hoping to find a different doctor as this one didn't seem to take my concerns seriously.

7-8 months ago I lost my first baby to a ectopic pregnancy(treated with methotrexate), now I’m officially pregnant 3 weeks and 4 days I have my first doctor appointment on the 21st of this month. I have so much anxiety about it being another ectopic pregnancy I haven’t been able to sleep. Last time I had headaches a lot and I was spotting for weeks until I found out. This time however I haven’t had any spotting but definitely implantation cramping in the middle of my lower abdomen. I’ve noticed on my right side I have slight aching here and there which is where the last ectopic was located but from what I read that’s normal ?? What’s really concerning me is this cramping/sharp pain on my left lower abdomen it comes and goes it’s not bad definitely not major and I’ve read it could be normal but I’m so nervous. Can anyone confirm these small pains are normal? And can anyone tell me their success stories?

Hi everyone,
I’m currently around 4 weeks + 5 days pregnant (based on timing/ovulation estimate), and I’m feeling quite anxious after my recent scan. I would really appreciate hearing from anyone with a similar experience.
My hCG levels are:
10.04 – 258
12.04 – 698
14.04 – 1637
The rise has been strong and consistent so far.
I had first transvaginal ultrasound at hCG 1637, and the doctor saw only a thickened endometrium consistent with early pregnancy, but no visible gestational sac yet.
I currently have:
No bleeding
No pain
Only mild breast tenderness
Otherwise no significant symptoms
The doctor said it may simply be too early, but I’m very anxious because I expected at least a small gestational sac to be visible at this level of hCG.
Has anyone had a similar situation where:
hCG was rising well
no sac was seen around ~1500–2000 hCG
and it still turned out to be a normal intrauterine pregnancy?
How long did it take before your gestational sac became visible?
Thank you so much for any experiences or reassurance.

After 6 months of ttc, I had an ectopic pregnancy at 7 weeks which sadly ended in a rupture, meaning I had to have emergency surgery at the start of february and lose my tube. It’s been a rollercoaster of emotions since then, but I can’t say I feel like time has “healed”. I have good days, but I also have overwhelming bad days where I could still sit and cry for hours about it all. I wanted that baby so much, and i feel so upset and guilty they never got the chance to be here.

I’m at the point where people seem genuinely surprised I’m still struggling so much, since so much time has passed, but I really do grieve my baby every waking second. I’m on the fence between, I’ll never apologise for having so much emotion towards my loss, and also criticising myself for being so sensitive and weak for not being able to move on. I’ve tried to access (free) counselling, but I’ve been rejected multiple times which makes me feel as if even the support systems don’t think I should be this upset.

Has anyone else felt so deeply affected by their ectopic? Does it actually ever get better, or is this something that everyone who’s been through it carries?

We’re still ttc, 3 months and no luck, and I think a rainbow would be the only thing that would pull me out of this storm but that feels so far away :(

I currently dealing with an ectopic pregnancy. My initial was over 8k and my most recent hcg was 11. I was treated with one shot of mtx. After mtx, I felt fine, just had bleeding like a period. Recently when my hcg was 50-30 I started to feel gas pain. Went to the ED a couple of times for it because it was soooo severe, worst pain I have ever felt. They just told me it’s residual left from my ectopic. The pain got better after taking Tylenol.
For those who experienced gas pain and bloating, when does it get better? When your nearing having an hcg of 0 or after your hcg is 0. I just want to go back to normal

Hello everyone. I am wanting to see if anyone has gone through something similar…
My last period was April 5th. (Started)
I found out I was pregnant May 9th. However May 12th I wiped and only had a very small amount of brown spotting and then I didn’t spot after that.
I went to the dr today and did a transvaginal ultrasound and was not able to find a sac and is worried I may have miscarried or have an ectopic pregnancy.
Could it be that I ovulated later than I was suppose to and I’m too early into the pregnancy? Supposedly I’m 5 weeks and 4 days…..
I am not experiencing any pain in my abdomen just lower back pain comes and goes like a period but that’s it. I’m not experiencing any severe pain or symptoms I am however starting to get nauseated.
I’m praying it’s not ectopic and I’m just too early. I’m sadden that it could be….

Hi everyone,

I recently had 2 doses of MTX shot, today was day 7 since 2nd shot and looks like my HCG is going down at an expected rate. I’m trying to figure out what to expect over the next few weeks/months.
My doctor told me to repeat blood work weekly until hCG is negative, and mentioned that it can take about 4–6 weeks. I was also told to follow a low folate diet until it’s negative. I’m a little confused about how strict that needs to be, especially since a lot of the healthy foods I usually eat are high in folate, like beans, lentils, quinoa etc.
I also asked about exercise, and I was told I could continue weights and HIIT if I was already doing them before. I used to work out intermittently until I ovulated, but I’m still unsure when people usually feel comfortable starting again more consistently.
I’m also worried about gaining a lot of weight during this waiting period. Since we have a 3-month wait before trying again, I’d really like to use this time to focus on being healthy again and reducing weight in a safe way.
For those who’ve been through this:

• How long were you told to stay on a low folate diet?and how long did it take for HCG to be negative?
• When did you resume working out?
• Did you modify your diet or exercise at all while waiting for hCG to go down?

I would really appreciate any advice you might have.

Hi all,

So im moving onto IVF after a failed iui back in january which resulted in ectopic.

Im so scared of having another bc i read it can also happen with ivf. Can i ask if you were successful after? Or did you have another ectopic with ivf?

TIA 🩷🙏🏼

Hi everyone,

I had an ectopic pregnancy in February and was treated with methotrexate on Feb 25. My HCG reached zero by the end of March and I’ve been cleared to start trying again in June.

Since the ectopic was on my left side, I’ve become really anxious about the idea of ovulating from the left ovary again. I know there’s no guaranteed way to know which side you ovulate from (or even which tube picks up the egg), but I still find myself wanting to only try on “right side” months.

Did anyone else feel like this after an ectopic? Did you eventually let go of tracking sides and just try naturally? Any success stories — especially from people who may have conceived from the same side — would really reassure me right now.

Any opinions or similar stories would be nice to know I’m not alone in this please. I’ve been dealing with a PUL that resulted in a salpingectomy on February 18th where they found no fetal or placental tissue in the tube upon pathology. Hcg started going down but then about 2 weeks after surgery it started going up again (day of surgery hcg was 1006 then went up to 1650). Had to get 2 methotrexate injections bc my hcg only went down by 13% with the first one. Those injections were in the first week of March, it is now the first week of May and my hcg still isn’t at 0, I’ve had on and off bleeding/ spotting since my surgery (I shed my decidual cast about 4 days after surgery). My doctor had me come in for an ultrasound last Friday bc she didn’t realize I was bleeding still. Ultrasound showed my surgery site was fine (even tho I’ve been cramping there for weeks) but she now sees a tiny sac in my uterus that has blood flow that she’s unsure of what it is🙄😅. I have had unprotected sex a few times through this whole process (my bf cannot cum with condoms😅) so she said there’s a small chance it’s a new pregnancy. She had me go that same day to get my hcg tested and it was at 56, over the weekend it went from 56 to 53 but from Monday to Wednesday it jumped up by 10 and is now 66. She did discuss that if this is not a new pregnancy I’ll probably need a D&C and at this point I just want to schedule it to get this over with bc I feel like it should not take 3 months or more to resolve this😅😭😭

I am 5 weeks 3 days pregnant. My HCG as of yesterday was 2706. I had severe cramping on my right side 2 days ago that lasted about 30 minutes. I fell asleep and napped about an hour, and woke up feeling fine and Thought nothing of it. Pain came back that evening on the right side. Went to bed for the night, and woke up with brown blood yesterday. The cramps turned more into manageable period cramps all day but I still went to my OB. They did an ultrasound and couldn’t see a sac in my uterus, although the lining was thick. The tech and doctor both said it’s possibly too early to see a sac. On my right side, they did see a small adnexal mass with some free fluid. I’m pretty much in a waiting game right now and it’s stressing me out! I go back in tomorrow to see if my HCG is doubling, then I’ll go back in for an ultrasound next week. My Dr wants to do another ultrasound before she confirms an ectopic (since I’m not bleeding heavy and my pain level is low now). Anyone have a similar experience?

Hi all, update from my last post, the Methotrexate one dose journey is on its way and I’m feeling a sense of relief that it is working and saw a 22% decrease on day 7. Here is my trends so far:

Day 1: 1489.15

Day 3: 1607.47 (had an ER visit for nausea that wouldn’t stop could have been a side effect from the methotrexate)

Day 4: 1784.89 (this is when I started feeling concerned that it wasn’t working but my doctor reassured me that it is typical to see an increase on day 4, I know they’re tired of me I’ve been calling basically almost every single day out of anxiety 😔)

Day 7: 1397.05 (22% drop)

I’m glad it’s working as expected but still feeling so many different emotions, a sense of relief, grief, numbness, depression, anxiety all mixed together and was wondering does it ever get easier? I feel comfort posting here and knowing I’m not the only one going through this as it can feel isolating at times, sending love and prayers to everyone

Hi everyone,
I’m 5 weeks pregnant and incredibly anxious due to my history. I had a previous ectopic pregnancy that resulted in the removal of my right fallopian tube last Marxh, so I only have my left one remaining.

My HCG numbers seem to be rising perfectly this time:
• Betas: 71 -> 265 -> 797 (all 48 hours apart).

Despite the good numbers, I’ve been feeling a lot of tightness and "heavy" pain/pressure on my left side, specifically in my lower back/flank area. I’m also constantly burping and very bloated, with no bleeding at all.
I’m terrified that this could be another ectopic in my remaining tube.

Has anyone experienced this kind of one-sided back/flank tightness early on after a previous ectopic and had it turn out okay?