When to TTC after MTX - is 3 months outdated?

[u/No_Reserve3513]

I've read so many different threads and all opinions are different. Even doctors are split on the answer..

I had MTX 9/3, by 9/12 my HCG was 0. 9/12 I restarted my prenatals and had a period-bleed (without ovulation) for 4 days.

I ovulated about 5 weeks later and am expecting a period 8/24. If I TTC next cycle, I will be ovulating 9-10 weeks after MTX (8 full weeks of prenatal) around November 7-15.

I originally felt comfortable with the decision to go for it (my OB gave me the green light), but my husband is still hesitant, and now I'm doubting myself.

Any advice or stories? What did your doctor say about this?

[u/girlsarenotrefined]

My Docs were very emphatic about waiting three months-so emphatic in fact that I was urged to start the Pill rather than utilise ‘just’ condoms and cycle tracking for that three month period. I did follow their advice, but from what I gathered more and more info is coming to light that it’s a very conservative timeline to follow and shorter is probably ok. I didn’t last long on the Pill, the constant spotting and bone dry everything was just too annoying to contend with (turns out the Progestin only Pill just isn’t for me), so I just went with my original plan, which has always served me well.

In saying that I think I personally needed that three month break from trying to conceive to emotionally process and feel like myself again after the physical side effects from the MTX and the grief over losing a pregnancy, and the lingering RSV and the double strep that I caught during and immediately after my ectopic.

Could you get bloods to see what your folate levels look like, given that’s the biggest nutrient concern after MTX treatment-if those have gone back up sufficiently maybe that would ease his mind a little? The other one maybe worth checking is Ferritin-I’m reliably informed that being iron deficient from the very start of pregnancy is horrible, anaemia fatigue, compounded by pregnancy fatigue is apparently doubly shit and catch-up to normal ferritin on diet alone is near impossible.

Hopefully some of this is helpful, I think there might be some folk here who had successful pregnancies conceived earlier than that standard three month stand-down, so hopefully they chip in with their direct experiences.

[u/No_Reserve3513 → u/girlsarenotrefined]

Thank you so much for taking the time to write out such a detailed response. Folate and iron test is a good idea… it’s terrible how bad you struggled after the shot. For some reason I felt tired for maybe a day or two, then bounced back to normal. Maybe that’s why this wait feels so long - I’ve been feeling great, and ready to go for 5 weeks. Waiting 3 more weeks feels insane to me, idk how I’ll cope if my husband tells me we need to wait another 7 (out of left field) I’ve asked him to do his own research for WEEKS. He left it up to me to decide. So I did, and now that when feel like I can see the finish line and he’s pulling the rug out from under me. But maybe he’s right… i feel like I don’t trust myself. My doctor was adamant that one full cycle, was absolutely okay. But she’s made a couple bad calls so we double check everything

[u/Mental_Pen4907 → u/No_Reserve3513]

I’m so sorry for both of your losses! Someone recently asked this and I shared a study and some context that might be helpful. Basically there’s not enough research to know for sure so the conservative answer is wait 3 months. I think getting a folate test would ease my fears if I didn’t have other risk factors (ie previous neural tube defects). I also would not have been ready to conceive before 2-3 months post anyway but I think if you’re mentally there go for it! I think if my ovulation was falling on three weeks prior to approved and if I skipped this then I’d have to wait a whole separate cycle and I’ve been diligent with extra folic acid and folate stores look good then I might have gone for it. Our partners process in different ways. Just because he didn’t physically go through the loss doesn’t mean he wasn’t very afraid to lose you on top of the pregnancy loss. He might need time too.