MTX and Pregnancy

August 21, 2001

Thanks for caring... it means alot to me to have a list such as this

to talk to and get information and support! I went to the doc and I

absolutely adore him but he won't treat my pa and fibro because he feels

there are better drugs for me than what he is comfy prescribing so he told

me to get a list of approved insurance docs and he'd pick one out that has

our goals and beliefs in treatments. A relief! For now I'm on Predinasone

and vicadin... I hate it and said I'd NEVER take predinasone but I'm able to

move around a bit more and take care of my child so it's something temporary

and doc just wants me to be comfy till we find me a doc. And I believe

after careful consideration, after all I went through with the child, I'd do

it all over again because he brings more joy in my life and it outweighs the

pain! Adoption is really a cool thing too , there are so many

children that need a good home (I was a court appointed child advocate for

MO) I guess it's like everything, you must weigh out wether the good

outweighs the bad and then decide on children. Just my thoughts... its late

and I'm rambling! Sorry so long

Dayton Ohio

>From: Boice <keboice@...>

>Reply-

>

>Subject: [ ] mtx and pregnancy

>Date: Tue, 21 Aug 2001 13:02:54 -0700

>

> >Now that I've had the lil booger however, I am really rock bottom.

> >Indocen worked

> >for a short while, now I feel worse. Going to the doc tonight. It is

>

>,

>

>Thanks for sharing your experience - keep us posted on your progress...

>

>Maybe I'll adopt :-)

>

> Boice

>

_________________________________________________________________

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December 14, 2004

I called and talked to the nurse, she said it is very important not

to get pregnant on MTX and you need 3 months to clean your system

out when you stop if you want to try and get pregnant. I asked about

enbrel and she said I couldn't get pregnant on that either and their

is a 6 week withdrawl on it. So I cried and have a prescription

birth control to go get. I will hope that I will go into remission

and maybe be able to try again for another baby before I get to old.

But I have been blessed with children and for now I need to be able

to walk and function for them.

It is very possible that your immune system is taking the

pregnancys. Taking baby asprin while pregnant is supposed to help,

it keeps the blood thin and helps keep the immune system away from

the baby. Of course my doctors don't know this is why I lose the

babies, it is just their educated guess, since I have nothing else

wrong with me or the babies.

Laurie

December 14, 2004

I'm so sorry laurie.

gentle hugs,

love, karen

>

> I called and talked to the nurse, she said it is very important

not

> to get pregnant on MTX ......So I cried and have a prescription

> birth control to go get. I will hope that I will go into

remission

> and maybe be able to try again for another baby before I get to

old....

> > Laurie

December 14, 2004

- So I cried and have a prescription

> birth control to go get. I will hope that I will go into remission

> and maybe be able to try again for another baby before I get to

old.

>

Hi Laurie,

I'm so sorry this disease has robbed you of a chance for another child

(at leat at the moment) I am SOOO glad you took the time to ask about

it. I am surprised your doc didn't mention this very important point

to you.

Take Care,

Marti

December 15, 2004

I am so sorry for your situation. Although I didn't have PA until after I

was done having children, I did have fertility issues. We had one child and

couldn't have another. We did drugs, surgery, etc. Finally we got pregnant

again. After years of trying for a third, I got thyroid cancer and decided

that was it. Three months after a test dose of radiation to make sure I was

still in remission, I got pregnant with my third.

After that history, I can get down to what I was going to tell you.

Yesterday, I leaned against the radiator at school and told a fellow

teacher, I can't believe I worked so hard to get these kids! The first

child is moving three states away and I don't know if I can stand it. The

second child is such a concern. I'm not anxious for him to go off to

college, because I'm so afraid he will go wild and not keep his room in a

sanitary state. Then, I still have a child in elementary school. I'm

pretty sure I will be moving into a nursing home when he moves out!

If I had stopped at the first child, we would now be relatively young adults

free to travel and free of homework! Although that gives you absolutely no

comfort right now, just remember that there is always a positive way to look

at any situation. And, no, I wouldn't trade my life for anything right now.

It just made me think back to how unhappy I was that I couldn't have more

children instead of feeling blessed for the one child I had.

My heart goes out to you. I know what you feel like every time you see a

pregnant woman or hear about someone abusing the children they have or find

out one of your relatives is expecting...

Ks Di

> - So I cried and have a prescription

> > birth control to go get. I will hope that I will go into remission

> > and maybe be able to try again for another baby before I get to

> old.

> >

> Hi Laurie,

>

> I'm so sorry this disease has robbed you of a chance for another child

> (at leat at the moment) I am SOOO glad you took the time to ask about

> it. I am surprised your doc didn't mention this very important point

> to you.

>

> Take Care,

> Marti

>

December 15, 2004

Hi Laurie, I'm so sorry that this disease is forcing you to make such a painful

decision. I hope things get easier for you and your family.

Take care,

Beth

--- momlaurie87 <tilly@...> wrote:

>

> I called and talked to the nurse, she said it is

> very important not

> to get pregnant on MTX and you need 3 months to

> clean your system

> out when you stop if you want to try and get

> pregnant. I asked about

> enbrel and she said I couldn't get pregnant on that

> either and their

> is a 6 week withdrawl on it. So I cried and have a

> prescription

> birth control to go get. I will hope that I will go

> into remission

> and maybe be able to try again for another baby

> before I get to old.

> But I have been blessed with children and for now I

> need to be able

> to walk and function for them.

>

> It is very possible that your immune system is

> taking the

> pregnancys. Taking baby asprin while pregnant is

> supposed to help,

> it keeps the blood thin and helps keep the immune

> system away from

> the baby. Of course my doctors don't know this is

> why I lose the

> babies, it is just their educated guess, since I

> have nothing else

> wrong with me or the babies.

> Laurie

>

March 6, 2005

I am embarrassed, scared and afraid. I've had a contraceptive failure. I

found out I am pregnant. Just barely but I am one week late and the test is

positive. I was taking 15 mg of MTX up until Feb 11 when I took my last dose. I

started Enbrel, took it for two weeks and promptly caught a virus and haven't

been taking it....... and now I find this out.

I know I should call the doctor's but you can't imagine how I feel right

now. I've essentially been deserted.

Has anyone been in or heard of a similar situation.

Abby

March 7, 2005

Abby,

Here are 3 studies showing the outcome of MTX usage in the first

trimester. In most cases, both mother and child were healthy. In

some cases, spontaneous abortion occurred. But in some of the

spontaneous abortion cases, these woman had this problem prior to MTX

usage, so that must be factored in. These woman also took mtx much

longer than you did. Please don't be embarrassed over this. It has

happened to many woman. It is very important that you make an

appointment with your doctor and tell them what happened. They can

determine the risks and discuss your options. They can do a test to

see if the baby is healthy.

J Rheumatol. 2004 Dec;31(12):2360-5.

Low dose methotrexate in the first trimester of pregnancy: results

of a French collaborative study.

Lewden B, Vial T, Elefant E, Nelva A, Carlier P, Descotes J;

French Network of Regional Pharmacovigilance Centers.

Centre Antipoison, Centre de Pharmacovigilance, 162 Avenue

Lacassagne, 69424 Lyon Cedex 03, France.

OBJECTIVE: To assess the risk of major malformations in pregnant

women with chronic inflammatory disorders treated with low dose

methotrexate (MTX) during the first trimester of pregnancy. Secondary

outcomes included the rate of miscarriage, birth weight, and

gestational age at delivery. METHODS: Data from the French network of

31 pharmacovigilance centers and 2 teratology information services

were analyzed. The outcome of pregnancy was prospectively assessed in

women exposed during the first trimester of pregnancy. Data on

maternal history and drug exposure were collected at the initial

inquiry, and on the outcome of pregnancy at followup. RESULTS:

Twenty-eight cases were available for analysis. MTX exposure ended

before 8 weeks of gestation in 26 patients. Miscarriages occurred in 4

patients and 5 had elective termination of pregnancy. There were 19

live births, among whom 3 were premature. Birth weights in full-term

children were within the expected range. One child exposed until 8.5

weeks of gestation had only minor anomalies (metatarsus varus and

eyelid angioma). CONCLUSION: Although no definitive conclusion can be

drawn, our results and the analysis of the literature support the

conclusion that no strong teratogenic risk is associated with low dose

MTX provided that the drug is discontinued as early as possible in

pregnant women.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15570635

Am J Med. 1990 Jun;88(6):589-92.

Outcome of first-trimester exposure to low-dose methotrexate in

eight patients with rheumatic disease.

Kozlowski RD, Steinbrunner JV, MacKenzie AH, Clough JD, Wilke WS, Segal AM.

Department of Rheumatic and Immunologic Disease, Cleveland Clinic

Foundation, Ohio 44106.

PURPOSE: Methotrexate (MTX), when used to treat malignancy or

psoriasis, has been implicated in anecdotal reports as a teratogen or

abortifacient in the first trimester of pregnancy. We are unaware of

any previous reports that describe the course of gestation and the

effect on subsequent offspring in patients treated with low-dose oral

MTX for rheumatoid arthritis, and therefore present our experience.

PATIENTS AND METHODS: We report on eight women experiencing 10

pregnancies. Mean number of weeks of gestation while taking MTX was

7.5 (range 2 to 20 weeks). Outcome of pregnancies included five

full-term babies (FTB), three spontaneous abortions (SAB), and two

elective abortions. RESULTS: There were no significant differences in

either the FTB or SAB group when considering risk factors including

smoking, alcohol, concomitant medications, and age. One of three in

the SAB group had recurrent abortions prior to MTX therapy. All five

of the FTB group had uncomplicated pregnancies and deliveries. All

offspring were of normal height and weight at birth with no physical

abnormalities. All children reached growth, development, and

intellectual stages normally, and their present mean age is 11.5

years. No observed learning disabilities or medical abnormalities have

occurred in any of these children. CONCLUSION: In this uncontrolled

study we failed to demonstrate tertogenicity of MTX. However, the

possibility of abortion due to MTX use remains.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=2\

189302 & dopt=Abstract

J Rheumatol. 2000 Aug;27(8):1872-5. Related Articles, Links

Low dose weekly methotrexate in early pregnancy. A case series and

review of the literature.

Ostensen M, Hartmann H, Salvesen K.

Center for Mothers with Rheumatic Disease, Department of

Rheumatology, University Hospital of Trondheim, Norway.

oestensen@...

OBJECTIVE: To assess the teratogenic risk of low dose weekly

pulses of methotrexate (MTX) inadvertently taken during the first

trimester of pregnancy. METHODS: We assessed pregnancy and neonatal

outcome of 4 patients with rheumatic disease treated with weekly

pulses of 5 to 15 mg of MTX for a mean duration of 4 years. RESULTS:

The 4 patients had continued MTX treatment from one to 6 weeks of

gestation. One patient miscarried at Week 6, the other pregnancies

ended with the delivery of healthy children. Chromosome analysis of

one child was normal. CONCLUSION: In spite of the absence of

congenital anomalies in our cases, safe contraception in fertile

patients who start low dose weekly MTX is mandatory.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=10955326

a

On Sun, 6 Mar 2005 23:52:33 EST, getcoffee@... <getcoffee@...> wrote:

>

> I am embarrassed, scared and afraid. I've had a contraceptive failure. I

> found out I am pregnant. Just barely but I am one week late and the test is

>

> positive. I was taking 15 mg of MTX up until Feb 11 when I took my last

> dose. I

> started Enbrel, took it for two weeks and promptly caught a virus and

> haven't

> been taking it....... and now I find this out.

>

> I know I should call the doctor's but you can't imagine how I feel right

> now. I've essentially been deserted.

>

> Has anyone been in or heard of a similar situation.

>

> Abby

>

March 7, 2005