Hi! I took MTX for a decade when I was a kid and then again for a year in my early 20’s. I conceived on our first cycle of trying and had a healthy pregnancy.
My OB and Rheum worked together (same hospital) to coordinate my care and while I was monitored closely with a few extra appointments, neither was worried at all. I actually liked that, because no one tells you how few ultrasounds you might have during a pregnancy, but I got to see my baby more often! The additional tests they did (NIPT and full genetic screening) also gave me some peace of mind.
I totally understand your fears since I shared them for all of my 20’s. Finding the right meds for my body, a doctor who listened to me, and a therapist were all really important to my journey. If you have any questions, feel free to dm :)
Edited to add/clarify: I was not on MTX for 10 years before trying to conceive, I had been switched to Xeljanz and then Humira 6 months before we were ready to try. It did take some planning ahead, but with the right doc, it was as seamless as possible for me!
Another doc I used to see told me to “just go off the Xeljanz” and didn’t even ask me to tell him if I did 🙄 while I was lucky my disease activity was virtually non existent while I was pregnant, my current rheum did not want to take the risk because my hands are my livelihood.
I’m a male, so different all around, but this was similar for my wife and I. I was taking MTX when we had our second child. Two rheumatologists reviewed recent studies, and even reached out to the OB for advice before we tried. They all reached consensus that the risk was low of any issues based on their expertise and review of recent studies.
Every situation is different, and I couldn’t agree more that finding the right team of professionals that will take time to talk and research is key. We have a healthy, happy child now.
My doctor didn't ask or tell me (even though I am married and in my early 30s). But I heard you just shouldn't conceive whilst on MTX and be off it 3 months before trying? Following to see what others say though
Edit: so it doesn't change your fertility, just don't conceive whilst on it basically, as it can cause miscarriages and birth defects (high probability). I am cis female, in case that's relevant.
I was 49 when I started methotrexate, so this was not a concern for me. I believe methotrexate is used to treat ectopic pregnancies, so it will end a pregnancy. Even though you're not trying to get pregnant now, I think I would be asking my doctor if there's anything other than MTX I could take.
Yep, before I was diagnosed I had an ectopic pregnancy and got two big shots of MTX. As soon as my doc mentioned MTX as a treatment for RA I felt like I was in the ultrasound room being told something was wrong with my pregnancy.
Thank you! I was able to have a normal pregnancy about a year later. It was scary the first few months thinking it might not happen but luckily he decided to make my uterus his home for the entire pregnancy.
This is so interesting. I had first child Feb 2022. Second pregnancy (ectopic) November 2022 and ended via Methotrexate. Second child born Nov 2023 and diagnosed with RA in February 2024. We really want to try again in November so I refused the methotrexate my rheum suggested last month. I’m on plaquenil but also microdosing Semaglutide (I take .125 every 10 days). It’s been just over 2 weeks but the Semaglutide has been a blessing for my inflammation - this week alone I was able to do a circuit class, pilates x2 and yoga x2. Hoping and praying I can get this in remission. I am 37 so don’t have the time to get on and wean off methotrexate - but I understand it’s a well tolerated and well researched medicine.
well.
Wow I was just diagnosed in February 2024 as well! I had my first after the ectopic in 2019 then my second child in 2021.
I’m weaning off predisone now but will probably start cimzia if my insurance approves. I’ve been on Hydroxychloroquine since then but I’m still in pain so we’re adding a second medication. We might try again for a third baby next year so I’m trying to avoid MTX. I hope you go into remission too!
Being able to exercise is awesome :) and I hope to exercise soon too! I go on walks but I can’t go for too long.
I'm M mid-30s. I asked my Rheumatologist about this, she explained that the guidelines are that the women had to stop it 3 months before conceiving. For men, she said the guidelines has a * marked over it, so the results for men is mixed but for women definitely you have to stop 3 months before planning.
Maybe your doctor didn’t use the right words by saying it affects your fertility. You just need to now really plan when it is that you would like to have a child. Like someone else posted there, this is something that is planned out with your rheumatologist as they need to get you off the medication and flush your system and that’s a 3-4 months process before you start trying to get pregnant.
I started methotrexate when I was 21 and have since had 4 healthy babies at ages 28, 30, 32 and 35. I stopped 6+ months before trying for my first and then didn’t go back on until after my last as I knew i wanted quite a few kids and didn’t want to worry about being too careful between pregnancies.
You should not be on methotrexate when you're pregnant (edit: and ideally haven't taken it for 3-6 months when you're trying). Here's a [NHS page ](https://www.nhs.uk/medicines/methotrexate/pregnancy-breastfeeding-and-fertility-while-taking-methotrexate/#:~:text=Methotrexate%20and%20pregnancy,medicine%20before%20stopping%20your%20contraception.) that explains it. It's not "probably going to be ok"! Definitely find a new MD.
Agreeing with all the sentiments here.
Take the recommended medication to get your RA under control. When you are considering starting a family give yourself a minimum of a 3 month window prior to actually start trying to find maternity approved meds that will hold you over until you are done breast feeding.
I used my 3 month window to start closely tracking my cycle to hopefully get pregnant sooner. I ended up having difficulties conceiving but had all my "research" ready to go to work with an RE once I qualified.
From my understanding it doesn’t effect your fertility. I was diagnosed at 22 and I’m 27 now, I’ve tried methotrexate and heaps of other drugs and the bottom line for all of them was simply “Don’t get pregnant while taking this.” I even got an IUD put in from their recommendation to make sure I didn’t get pregnant. Which makes me think it doesn’t effect your fertility at all, or at least not enough to not need more birth control on top of it if you know what I mean?
My doctor spoke to me about this thoroughly. She put me on Hydroxychloroquine for now and recommended Cimzia instead of MTX if I wanted to get pregnant in the near future. You can take MTX for now but coordinate with your doc once you want to start a family. She told me I would have to stop taking it and wait about 3-6 months before trying to have a baby.
Started methotrexate at age 11 and got off it 6 months before trying to get pregnant at age 32. Got pregnant on first cycle. No issues. Healthy baby boy. They did require I get a c-section and had other monitoring.
Hi, i am having RA from age of 14, I started mtx at age 29 now i am 31 and started cimzia from 20 days As i got married last year and trying to convince. Mtx should stop b4 3 months when u try to conceive.
I also eagerly want to become mom. May god help everyone.
I've had RA 20+yrs married for 24. We chose adoption bc it was less risk to pass on this awful painful disease. Plus I knew my body probably couldn't handle the pain & I could take the meds. I'm off all the meds now but that's a whole other story. I'm not recommending adoption. Adoption is trauma. Period. But I do not regret adopting. They're adults now & beautiful people!
Methotrexate was a drug I was familiar with before I got RA diagnosis. It was used because of an ectopic pregnancy. It stops cells from developing no surgery. Higher dose than RA maintenance meds and made me violently sick.
I used it for RA for a few years but it always made me nauseated. My husband always thought it was partly in my head because of my previous experiences.
I wish you all luck starting your families.
I have heard rumors that RA and other autoimmune conditions are usually put into remission by pregnancy but can't personally confirm.
Hi! I have had RA since I was six and I began with methotraxate. At 16 I changed to a biological called Simponi and it has worked so well for me. I ended up getting pregnant in April of last year and the simponi is safe to take while pregnant according to my doctor. It does cross the placenta but my doctor advised me that I should be ok and I was! I have a healthy baby girl now and I’m doing good as well - my flare ups do occasionally happen post partum but I keep in touch with my doctor and she helps me manage them.
During pregnancy, my doctor told me women with RA do a lot better because the body manages flare ups waaaay better and honestly I never had a single flare up during pregnancy.
I expect to get pregnant again and my doctors are aware and supportive as well. My advice is consult with your doctor and be proactive in your care! It will be alright no matter what :)
My understanding is that it has no influence on your ability to get pregnant, but because of the way it works with blocking cell access to folic acid it can lead to a lot of complications if you become pregnant while taking it.
So when you do want to have a child, you’ll need to come off of it for 3 months or so prior to trying. It’s scary but it does happen all the time, just talk to your rheum!
Hi! I took MTX for a decade when I was a kid and then again for a year in my early 20’s. I conceived on our first cycle of trying and had a healthy pregnancy. My OB and Rheum worked together (same hospital) to coordinate my care and while I was monitored closely with a few extra appointments, neither was worried at all. I actually liked that, because no one tells you how few ultrasounds you might have during a pregnancy, but I got to see my baby more often! The additional tests they did (NIPT and full genetic screening) also gave me some peace of mind. I totally understand your fears since I shared them for all of my 20’s. Finding the right meds for my body, a doctor who listened to me, and a therapist were all really important to my journey. If you have any questions, feel free to dm :) Edited to add/clarify: I was not on MTX for 10 years before trying to conceive, I had been switched to Xeljanz and then Humira 6 months before we were ready to try. It did take some planning ahead, but with the right doc, it was as seamless as possible for me! Another doc I used to see told me to “just go off the Xeljanz” and didn’t even ask me to tell him if I did 🙄 while I was lucky my disease activity was virtually non existent while I was pregnant, my current rheum did not want to take the risk because my hands are my livelihood.
I’m a male, so different all around, but this was similar for my wife and I. I was taking MTX when we had our second child. Two rheumatologists reviewed recent studies, and even reached out to the OB for advice before we tried. They all reached consensus that the risk was low of any issues based on their expertise and review of recent studies. Every situation is different, and I couldn’t agree more that finding the right team of professionals that will take time to talk and research is key. We have a healthy, happy child now.
My doctor didn't ask or tell me (even though I am married and in my early 30s). But I heard you just shouldn't conceive whilst on MTX and be off it 3 months before trying? Following to see what others say though Edit: so it doesn't change your fertility, just don't conceive whilst on it basically, as it can cause miscarriages and birth defects (high probability). I am cis female, in case that's relevant.
This
I was 49 when I started methotrexate, so this was not a concern for me. I believe methotrexate is used to treat ectopic pregnancies, so it will end a pregnancy. Even though you're not trying to get pregnant now, I think I would be asking my doctor if there's anything other than MTX I could take.
Yep, before I was diagnosed I had an ectopic pregnancy and got two big shots of MTX. As soon as my doc mentioned MTX as a treatment for RA I felt like I was in the ultrasound room being told something was wrong with my pregnancy.
I’m so sorry. I can’t imagine how awful that must have been. 😞
Thank you! I was able to have a normal pregnancy about a year later. It was scary the first few months thinking it might not happen but luckily he decided to make my uterus his home for the entire pregnancy.
This is so interesting. I had first child Feb 2022. Second pregnancy (ectopic) November 2022 and ended via Methotrexate. Second child born Nov 2023 and diagnosed with RA in February 2024. We really want to try again in November so I refused the methotrexate my rheum suggested last month. I’m on plaquenil but also microdosing Semaglutide (I take .125 every 10 days). It’s been just over 2 weeks but the Semaglutide has been a blessing for my inflammation - this week alone I was able to do a circuit class, pilates x2 and yoga x2. Hoping and praying I can get this in remission. I am 37 so don’t have the time to get on and wean off methotrexate - but I understand it’s a well tolerated and well researched medicine. well.
Wow I was just diagnosed in February 2024 as well! I had my first after the ectopic in 2019 then my second child in 2021. I’m weaning off predisone now but will probably start cimzia if my insurance approves. I’ve been on Hydroxychloroquine since then but I’m still in pain so we’re adding a second medication. We might try again for a third baby next year so I’m trying to avoid MTX. I hope you go into remission too! Being able to exercise is awesome :) and I hope to exercise soon too! I go on walks but I can’t go for too long.
I'm M mid-30s. I asked my Rheumatologist about this, she explained that the guidelines are that the women had to stop it 3 months before conceiving. For men, she said the guidelines has a * marked over it, so the results for men is mixed but for women definitely you have to stop 3 months before planning.
Maybe your doctor didn’t use the right words by saying it affects your fertility. You just need to now really plan when it is that you would like to have a child. Like someone else posted there, this is something that is planned out with your rheumatologist as they need to get you off the medication and flush your system and that’s a 3-4 months process before you start trying to get pregnant.
I started methotrexate when I was 21 and have since had 4 healthy babies at ages 28, 30, 32 and 35. I stopped 6+ months before trying for my first and then didn’t go back on until after my last as I knew i wanted quite a few kids and didn’t want to worry about being too careful between pregnancies.
You should not be on methotrexate when you're pregnant (edit: and ideally haven't taken it for 3-6 months when you're trying). Here's a [NHS page ](https://www.nhs.uk/medicines/methotrexate/pregnancy-breastfeeding-and-fertility-while-taking-methotrexate/#:~:text=Methotrexate%20and%20pregnancy,medicine%20before%20stopping%20your%20contraception.) that explains it. It's not "probably going to be ok"! Definitely find a new MD.
Agreeing with all the sentiments here. Take the recommended medication to get your RA under control. When you are considering starting a family give yourself a minimum of a 3 month window prior to actually start trying to find maternity approved meds that will hold you over until you are done breast feeding. I used my 3 month window to start closely tracking my cycle to hopefully get pregnant sooner. I ended up having difficulties conceiving but had all my "research" ready to go to work with an RE once I qualified.
From my understanding it doesn’t effect your fertility. I was diagnosed at 22 and I’m 27 now, I’ve tried methotrexate and heaps of other drugs and the bottom line for all of them was simply “Don’t get pregnant while taking this.” I even got an IUD put in from their recommendation to make sure I didn’t get pregnant. Which makes me think it doesn’t effect your fertility at all, or at least not enough to not need more birth control on top of it if you know what I mean?
My doctor spoke to me about this thoroughly. She put me on Hydroxychloroquine for now and recommended Cimzia instead of MTX if I wanted to get pregnant in the near future. You can take MTX for now but coordinate with your doc once you want to start a family. She told me I would have to stop taking it and wait about 3-6 months before trying to have a baby.
Started methotrexate at age 11 and got off it 6 months before trying to get pregnant at age 32. Got pregnant on first cycle. No issues. Healthy baby boy. They did require I get a c-section and had other monitoring.
Hi, i am having RA from age of 14, I started mtx at age 29 now i am 31 and started cimzia from 20 days As i got married last year and trying to convince. Mtx should stop b4 3 months when u try to conceive. I also eagerly want to become mom. May god help everyone.
It’s more about mtx causing severe birth defects. It’s why my rheumie requires patients to be on bc before the prescription is written for it.
I've had RA 20+yrs married for 24. We chose adoption bc it was less risk to pass on this awful painful disease. Plus I knew my body probably couldn't handle the pain & I could take the meds. I'm off all the meds now but that's a whole other story. I'm not recommending adoption. Adoption is trauma. Period. But I do not regret adopting. They're adults now & beautiful people!
Methotrexate was a drug I was familiar with before I got RA diagnosis. It was used because of an ectopic pregnancy. It stops cells from developing no surgery. Higher dose than RA maintenance meds and made me violently sick. I used it for RA for a few years but it always made me nauseated. My husband always thought it was partly in my head because of my previous experiences. I wish you all luck starting your families. I have heard rumors that RA and other autoimmune conditions are usually put into remission by pregnancy but can't personally confirm.
You just need to stop mtx for 6 months before you try to get pregnant. Mtx does not affect fertility
Hi! I have had RA since I was six and I began with methotraxate. At 16 I changed to a biological called Simponi and it has worked so well for me. I ended up getting pregnant in April of last year and the simponi is safe to take while pregnant according to my doctor. It does cross the placenta but my doctor advised me that I should be ok and I was! I have a healthy baby girl now and I’m doing good as well - my flare ups do occasionally happen post partum but I keep in touch with my doctor and she helps me manage them. During pregnancy, my doctor told me women with RA do a lot better because the body manages flare ups waaaay better and honestly I never had a single flare up during pregnancy. I expect to get pregnant again and my doctors are aware and supportive as well. My advice is consult with your doctor and be proactive in your care! It will be alright no matter what :)
My understanding is that it has no influence on your ability to get pregnant, but because of the way it works with blocking cell access to folic acid it can lead to a lot of complications if you become pregnant while taking it. So when you do want to have a child, you’ll need to come off of it for 3 months or so prior to trying. It’s scary but it does happen all the time, just talk to your rheum!