Hi, Since you are already under direct supervision and observation of your attending physician / gynecologist, they must have given due consideration in excluding every other possibility of lower abdominal pain. Although the following could be the approach: - In females, consult a gynecologist or take a second opinion for any underlying pathologies like endometriosis, uterine fibroids or pelvic inflammatory disease (PID). If after the pelvic examination the doctor suspects an underlying condition, they may order investigations like MRI, CT, hysteroscopy, laproscopy since surgery may be needed to remove the abnormal tumor. PS. After you take methotrexate, you may have mild to moderate cramps or pain in the abdomen, with vaginal bleeding. Yet, since it is a medical management, go to an emergency department to check whether your tubes are ruptured or not. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Munish Sood, Ayurveda Specialist