Subject: Methotrexate and pregnancy guidance
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
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