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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 yrs experience, awarding winning educator
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I was adviced by Dr. C on my ectopic pregnancy. And she said

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I was adviced by Dr. C on my ectopic pregnancy. And she said that I need to avoid alcohol for sometime. Can you please advice for how long do I need to abstain from alcohol? Also, I understand I need to abstain from sex. Can you please also let me know
? TIA
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. C. replied 2 years ago.
Hi, It's Dr. C again. Usually refraining from alcohol wouldn't be specific advice we'd give a woman dealing with an ectopic. Let me see if I can find the question to review the context. I was able to find the question and do remember you. There isn't anything specific in the question about alcohol. But we do have women refrain from alcohol while undergoing methotrexate treatment. So this is probably something that the doctor giving you the medication told you. This is because methotrexate can impact liver function and since alcohol also impacts the liver, we prefer patients not use both at the same time. Once the treatment is over, there is no restriction on alcohol. It's been enough time that this is not an issue anymore. So feel free to have some at this point. Usually a woman can resume sex once it's clear that the methotrexate has worked and the danger of the ectopic has passed. There is also some benefit to avoiding pregnancy the very first cycle after an ectopic. The risk of miscarriage is likely higher if a woman gets pregnant the very first cycle after a pregnancy loss no matter the cause. I hope this was helpful. Please ask questions if I can clarify anything.
Customer: replied 2 years ago.
Glad to have you back again!!!! :-)
Actually, for my doctor, this was the first time he had ever used methotextrate treatment. Apparently, in the Netherlands, where I live, the standard operating procedure with women with ectopic pregnancy is to simply remove the tube where this pregnancy occurred (irrespective of the size of the remnant tissue/pregnancy and irrespective of the hcg levels) - the thought behind this being, that the chances of the ectopic happening in the same place increases if they leave the tube and treat only the remnant tissue/pregnancy. I had to fight tooth and nail to get this treatment - only 1 doctor in Amsterdam had any experience with it, and my doctor had to take advice from him on how to administer the medication. I am telling you this, because he didn't tell me anything in terms of precautions - whatever i learnt was either by reading online or asking you. Hence, he has no clue what to do and what not to do and until when. He was unhappy actually after my first blood result, because the drop in his opinion was only 25%, which is most probably untrue because he didnt test me on day 4 t osee how much my hcg has initially risen...
So, in your opinion, can i start drinking maybe once in 2 weeks? I am not a drinker, but every 2-3 weeks, we like to got for dinner, and I would like to have a small glass of wine perhaps..
also, on Tuesday - July 14, my hcg was 86... just to let you know.
We tried naturally to get pregnant for 1 whole year, after which I had 6 cycles of clomid (1 cycle 25 mg, 5 - 50 mg - this made my period cycles remain stable at 29-30 adys as opposed to 32-34 days), and in the 7th round - I had clomid + 1 injection of ovitrelle - which led to this ectopic pregnancy. Do you think I will have a risk of getting pregnant should we have sex, without these medications? (Since you have mentioned to avoid getting pregnant until the next cycle). Also, how many cycles should we really wait on this, because we can begin to try again?
Expert:  Dr. C. replied 2 years ago.
I'm glad that you fought for this because the research does support the use of methotrexate. Yes it's fine to resume drinking now since the treatment medication has been metabolized from your system at this point. Moderate alcohol intake for a woman is up to 1 daily or 7 per week. Because you were undergoing infertility treatment, the risk of spontaneous pregnancy in the first cycle following the ectopic is lower than average but not zero. Timing of the next attempt should be after the beta-hcg is < 5, then perhaps 1-2 months. Because you're using clomid to achieve pregnancy, the reset of the lining is less important since it's not clear that your regular cycles are hormonally normal anyway.
Customer: replied 2 years ago.
perfect! Thanks...so thankful to God, that my medication is working properly
I want to check with you what should be my plan of action for getting pregnant - should I still try getting pregnant the "routine" way with clomid and ovitrelle, or given my age (36, and we want to have 2 children) and my history of ectopic pregnancy + PCOS (metformin 2000mg daily) + Thyroid imbalance (75mg pill daily) - should I look for alternatives? (Artificial insemination/ivf/ not sure?) - Doctors in The Netherlands have a standard operating procedure - They will insist on the "routine" route, and will only suggest ivf if I no longer have any fallopian tubes and/or I am over 40 - this is the procedure here. But, I would like your advice on what the logical next steps are.
Expert:  Dr. C. replied 2 years ago.
Usually we would go with no more than 4-6 cycles of Clomid with washed insemination before switching plans to IVF. That would include the ectopic cycle. So it would depend on how many Clomid cycles have already been completed. The thyroid doesn't impact things. With regards ***** ***** there is some evidence that taking the supplement myo-inositol helps regulate the ovulation. It may improve response to Clomid and Metformin as well, although there isn't research on that.
Customer: replied 2 years ago.
i have had 6 cycles of clomid + 1 cycle clomid + ovitrelle. No washed insemination. Is that what I should opt for as a next step now? are there risks of ectopic occurances?
Expert:  Dr. C. replied 2 years ago.
Is there a perfectly normal semen analysis? If not, the washed insemination would be the next step. If the semen is perfectly normal, it's time to move on from Clomid to more intense treatments. Yes there is an increased risk of ectopic in future pregnancies including IVF. It ranges from about 10-25%.
Customer: replied 2 years ago.
yes, semen analysis was perfectly normal. Any way to reduce chances of ectopic?
Customer: replied 2 years ago.
and what would you mean by "more intense treatments"?
Expert:  Dr. C. replied 2 years ago.
Not really. With embryo transfer it's lower but IVF is not protective. Anything else?
Dr. C. and other OB GYN Specialists are ready to help you
Customer: replied 2 years ago.
that is all for this time. You r great - thanks!
Customer: replied 2 years ago.
hi, Can I a question - yesterday my hcg was 22, but the size of the tissue matter is still at 0.77 cms. It has not fallen much. In 1 week, it have gone from 0.90cms to 0.77cms. Do I need to worry? I started some bleeding today, so I am concerned. Can you help?