Methotrexate and pregnancy

Katie2012

Hello!

My name's Katie, I'm 27 and I have had fairly mild RA for about 10 years now.

I have been on Methotrexate for about the past 7 years (with a short break at one point), and have been generally well controlled during the time I have taken it. However, I am now at the point where me and my husband would like to start thinking about trying for our first baby (ideally we'd start trying in July/August this year) and so I need to start thinking about stopping Methotrexate.

When I first spoke to my usual consultant about this, she recommended stopping the Methotrexate for 6 months before trying to get pregnant. However, when I next went to the hospital I was seen by a different consultant as mine was on a sabatical. The new consultant, who mentioned that she had worked in a hospital specialising in RA and pregnancy in Canada, said that she would recommend only stopping the Methotrexate 3 months prior to pregnancy, as this was adequate to allow the Methotrexate to leave the system and also put me at less risk of a flare.

Since seeing her, I have done a lot of internet research and am now more confused than ever! I have found a range of information about both 3 and 6 months being the recommended amount of time - so which is right?! I don't know whether the UK government is just playing it safe with the 6 month recommendation, as most of the 3 month information I can find is from elsewhere in the world, but it's hard to be sure.

Part of me thinks that it would be better to play it safe and have 6 months Methotrexate free before starting to try, as I'd never forgive myself if I got pregnant and something was wrong with the baby and I thought the Methotrexate was to blame. However, I'm also aware that it can take quite a while to conceive, and that if I wait 6 months before even starting I could easily end up spending a year or longer off the Methotrexate before falling pregnant.

I'm going to make another consultant appointment ASAP, as if I am going to wait 6 months I would like to come off the Methotrexate soon, but I want to feel like I'm armed with evidence/ideas before I go - otherwise I tend to get a bit overwhelmed and just agree to whatever I'm told to do without even thinking about it!

If anyone has any experiences to do with Methotrexate and pregnancy I would love to hear them, or just any advice. I guess I just feel really alone in this decision, especially as I haven't told many people that we're planning to try for a baby as I don't want everyone to be waiting for the announcement just incase it takes a while to happen! My husband is being really supportive, but I think he's even more scared than I am about making the wrong decision and is also very aware that it's my body and my health and not his.

Hope to hear from some of you soon,

Katie x

stickywicket

Hello Katie and welcome to the forum. I can see where you're coming from having had two different stories about how long you need to be off the meth for before trying for a baby. It would seem that the consultant who gave you the shorter time is maybe a bit more of an expert in the field but, would I persoally take one person's word for it in your circumstances? No.

I can't help, I'm afraid but we do have Mums, and prospective Mums on here and I hope one of them will be alone soon. You might find some relevant threads if you type 'methotrexate and pregnancy' into the search engine - top right.

Colin1

Hi Katie
I have read all sorts from the internet as this question has come up on here in the past . I agree its very confusing i've read women should wait at least one menstrual cycle before trying, others say 6 months and some say at least three months. If i where you i would go for the longer period that i could because of the folic acid thing and to make sure the drug was well out of my system. Its scary stuff love and glad i'm a man
If you take charge of the situstion and ask the Rheumy for another med during the waiting period or something to have on standby. I dont quite know what else to say. Take care and i hope all goes well
Colin

frogmorton

Hi Katie

Lovely to meet you. l was lucky enough to have my girls before all this started so have no personal experience of this.

In your position though l would be probably way to scared to leave it less than 6 months and of course you do need folic acid every day when trying to conceive dont you??

Have they told you which drugs you CAN take safely??? Some get by with low doses of other meds to 'tide them over'

Tricky one isn't it??

Do let us know how you get on

Love

Toni xx

Katie2012

Thanks for all of your replies

I think I'm feeling pretty set on the 6 months right now,seeing all of your comments has really helped me get my head around it. Also had a pregnant collegue at work have a scare today,which has made me think about what a risky business pregnancy can be anyway even without throwing methotrexate into the mix!

I've made an appointment to see my consultant next Friday,so I guess that will be when I stop the Methotrexate - scary stuff! I'd ideally like to be off all medicines when I conceive and throughout pregnancy,but I guess I'll just have to play it by ear and see how things go.

Thanks again for your advice,

Katie x

spottidotti

Hi Katie

When i read your post i thought it only right that i register and let you know my experience.....

I am currently 38 weeks pregnant and heres how i got here!!

BTW i'm 26 and had RA since i was 20.

In 2010 i was taking methotrexate, sulfasalazine and having humira injections.

Personally I wasn't too worried about having a flare up and more concerned with having all traces of the drugs out of my body before trying to conceive and so 6 months was the only option for me although i had read about the 3 month period also.

With regards to the sulfasalazine i was advised to stay on it until conception which i thought was crazy. Apparently it is known to be much safer than other drugs but I came off it at the same time as the methotrexate, i really wanted to be completely drug free for a full 6 months.

So August 2010 stopped all meds. In the 6 months that followed i did have a flare in the first month, both my knees swelled up badly and had them drained and injected with steroids to sort them out. At this point i admit i was anxious about how the next few months would turn out but never regretted stopping all the meds. After that flare i am very happy to report my knees recovered and for the rest of the 6 months i felt pretty much as if i was still on the meds.

After the 6 months it took another 4 months to conceive. So in 10 months just had one flare at the start. Like you say one of the concerns is how long it will take to conceive but fortunately for us it was a relatively short time, i was prepared for at least a year!

Since being pregnant my arthritis has improved and i've felt better than i have done in years. Over the last few weeks i have started to feel the strain with the extra weight but that was to be expected.

I was told early on that 75% of women with arthritis who become pregnant feel better because of the hormonal changes your body goes through and this has certainly been the case for me!

I was also told to expect a flare up after the birth because of the stress your body goes through, i'll find out soon if this is true!

All in all i wouldn't change anything from the past year and a half and if i could remain pregnant all the time i probably would, not sure what hubby would say

Anyway just wanted to let you know my story so far, hope its helped a bit......

Stay positive and confident in the decisions you make and hopefully things will work out well for you too,

good luck for the coming months

Dotti x

skezier

Hi Katie,

I just wanted to wish you so much good luck and hopes.

There have been a few mums who have now got their babies and somewhere there is a very long thread on pregnancy. If you use the search engine you should find it cus its a common topic obviously.

I hioe the appointment goes well and well i just wanted to say good luck and fingers crossed they will do everything they can to help you. Nice to meet you. Cris x


Hi Dotti,

That was so good to read and congratulations to you and your oh. I so hope the flare wont be as big as you think and it all goes well. Nice to meet you too. Cris x

tkachev

Hi just want to say I took sulfasalazine right through my pregnancy. My daughter was fine. None of the medical staff seemed at all concerned about it( baby was unplanned so was carrying on with my meds when I discovered I was pregnant. I wasn't on humira or MTX at that time).

I did have a mega flare after the birth and R.A went on a whole new level so just make sure you have follow up appointment arranged to be on the safe side.

Congratulations to Dotti and thank you for sharing your story. Let us know how it goes.

Elizabeth x

julie47

Hi Katie

My Ra came on just after the birth of my daughter so I am in no position to advise. I just wanted to drop in and wish you well.

Take care
Juliepf x

Katie2012

Thanks again for everyone's helpful and supportive messages - it really does make me feel a bit less alone with all of this.

Dotti - how exciting! Good luck with the next few weeks! Cross fingers it won't be too long 'til you get to meet your little one

I'm finding it really strange at the moment - I know it's ages 'til I can even start trying,and I don't want to get my hopes up too much or get too excited,but at the same time stopping the methotrexate is making it all seem very real! Just keep looking at mums and babies and thinking that I cannot WAIT for that to be me Cross fingers!

xxx

stlucia

Hi I'm going through the same thing at the moment and am writing a blog about arthritis and pregnancy. You can find the address for it if you click on my name (it's on the info bit on my profile). I hope you find it useful xx

MissKat

Hi Katie,

Thanks for starting this thread as it's something I've been looking into recently too... it's been very helpful reading everyone's thoughts.

My consultant when I first started on Methotrexate said to come off it 6 months before trying to conceive, he said that some people say 3 months, but he'd recommend 6 just to be sure it was all out of your system.

Thanks to Dotti for your story - it gives us great hope Good luck with your little one!

Good luck to you too Katie - an exciting adventure ahead of you. Please keep us updated... would be very interested to hear of your experience as I don't think I'll be too far behind you

MissKat x

stlucia

Hey Katie, I just wondered how your appointment went? Were they helpful.
Lucia x
www.operationuptheduff.blogspot.com My blog about JIA and pregnancy