Methotrexate is a commonly prescribed medication used to treat ectopic pregnancies. Ectopic pregnancy is defined as any pregnancy growing outside the uterus. It is most commonly found in the fallopian tube. In vitro fertilization, tubal damage, having an IUD in place, and smoking all increase your chance of having a tubal pregnancy.
Methotrexate is the preferred medical treatment for ectopic pregnancies and has been used for more than 25 years. It is given via an intramuscular injection (at InVia, it is usually given in the office by a member of the nursing staff). It works by being highly toxic to rapidly replicating tissues (such as an embryo). Your doctor will evaluate if it is safe to give you Methotrexate before ordering the medication. This evaluation includes various labs and an ultrasound. Methotrexate success ranges from 78-96%, but it can take 4-8 weeks for HCG levels to return to normal. Occasionally, if the HCG does not begin to decrease as expected, a second dose of Methotrexate is given. Side effects of Methotrexate include gastric upset, nausea and/or vomiting, and dizziness. Patients will be instructed to discontinue taking any folic acid supplements, including a prenatal vitamin, until directed.
Many patients ask…will I be able to get pregnant again? Yes, you can most definitely get pregnant after receiving Methotrexate. Weekly HCG levels will be drawn to ensure the level is down to negative before being given the clearance to attempt another pregnancy. Diagnostic tests after receiving Methotrexate showed tubal patency (open tubes) in 78% of cases and 65% of patients went on to achieve a subsequent pregnancy. While there is still a risk of another pregnancy resulting in an ectopic pregnancy again (approximately 8%), your healthcare provider will monitor early HCG levels looking for abnormal rises that may signify an abnormal pregnancy or ectopic pregnancy.
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