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The Cancer in Pregnancy Forum

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This Forum has been the centre of an exceptional exchange of knowledge diagnosis, treatment, symptoms and other effects of cancer during pregnancy and lactation. All are welcome to review the Questions and Answers posted here, provided that they acknowledge and accept the important proviso and disclaimer below.
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Forum > Cancer - Active Topics: Cancer - Active Topics
Teatment with methotrexate prior to conception

CCoPE
Date: 2007-02-01

Question:
I was recently injected with methotrexate (2 ml) to address an ectopic pregnancy (I am still waiting to learn if further injections will be required). I have two questions about this: 1) Assuming this treatment works, when will it be safe to start trying to get pregnant again? 2) Since I understand that methotrexate affects folic acid levels, should I continue folic acid supplementation (0.4 mg/day) and is there any need to increase the level of supplementation? Thanks for your great website!

Answer:

Consult your physician. The following information should not replace the assessment and advice you have been receiving from your physician (cancer specialist, obstetrician, or any other healthcare provider). It is offered for your information only.

Methotrexate is a structural analogue of folic acid and because of its short half life, it will not stay in the body for more than a few days. There have been reports of women who have discontinued methotrexate prior to conception and they delivered healthy infants without birth defects (Briggs 2005). Several sources have suggested that women wait at least 12 weeks after stopping therapy before conceiving (Ann Int Med 1977;86:1999). It is sensible for you to take 5mg of folic acid, as it gives better protection, and especially because you received an antifolate drug (methotrexate).

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