Q&A

Here is a copy of an email I sent to my MD, he called me and we discussed the answers, which are noted in red below.


1. The US that is done prior to the MTX injection, will it tell definitively if this is a tubal vs uterine pregnancy? Small changes in the lining of the endometrium may be viewed if the embryo is indeed in the uterus. We will not see an embryo and possibly not a sac, but there can be endometrium changes that are visable.

2. If not, when can we tell by ultrasound if this is a tubal or uterine pregnancy? Should be able to tell the day of the US

3. If the pregnancy is not developing appropriately, and it is not a tubal pregnancy, then what is the harm in letting the body naturally miscarry?
No problem doing this if it makes me more comfortable

4. What are the risks and advantages to having the MTX injection? Biggest benefit is if there is a tubal pregnancy avoids a potentially life-threatening situation

5. Do you have a copy of the informed consent that you can send to me to view ahead of time? Sent to me via email

6. Matthew indicated that according to Dr. Galen the count needed to be 350 or greater on Wednesday. What if it is something like 317? Do we still give up? The likelihood of failed pregnancy is great if numbers are not doubled at this time, however, given that it is uterine, I can carry it until it naturally miscarries.

I do not want to take the MTX unless absolutely necessary. To me absolutely necessary means that my life is in imminent danger, not a 5-6% risk of danger from a tubal pregnancy that may or may not exist. The choice is always mine, this is just what he recommends

Women not receiving IVF get one positive pregnancy test, are told to take their vitamins, and not seen for another month by their OB/GYN. I am not sure what the rush is with an IVF cycle. There are higher instances of tubal pregnancies with tubal reversals and IVF, both of which I have.

I know I am being difficult, nurses are the worst patients, and I need all the information to make a good decision. We all know this is true!

Thanks,

Theresa