Any successful expectant management stories?

Main Board
1

Hi! So, I’m currently a few days into expectant management for a very early ectopic pregnancy and I wondered if anyone had gone down this route with a positive outcome? It seems to be said a lot but despite trawling forums for these stories, this method seems to be the least trodden path.

For background, I had a mmc at the beginning of May and was waiting for my next period to return and for my cycle to resume. My period did arrive, right as expected and I was pleased to be able to start tracking ovulation. The day after my period ended I started feeling a dull ache one one side of my abdomen which prompted me to do an LH test, as I thought I could be gearing up to ovulate, which would have been pretty much impossible/too early. Got a blazing positive on that which completely confused me, and eventually lead me to take a pregnancy test. Got a very faint positive so I assumed I’d had a chemical pregnancy, which I was totally fine with as I wasn’t expecting to have fallen pregnant so close to the miscarriage and I didn’t think my body would be ready anyway.

The next day, instead of the lines of my pregnancy tests getting lighter, they got darker and I immediately knew something wasn’t right. Thankfully I was very aware that ectopics can happen and after much frantic googling and researching, I got an appointment with my epu and they scanned me. At first, they told me there was a small mass in my tube but this was most likely swelling from a bleed, but I just knew this wasn’t right. They took my bloods and requested I do them again in 48 hours to be able to have an idea of what was happening. My levels went from 87 to 76, which again suggested ectopic.

I told the nurse who gave me the results that I was 99% sure this was an ectopic pregnancy despite the fact they were unsure and they told me to come back for another scan (this was yesterday). The scan confirmed an ectopic pregnancy on my right side which is bizarrely the opposite side to the ache I was feeling- pure chance that I spotted this!

The consultant said that because my hcg is so low and the pregnancy so small at this stage, they would advise expectant management for now. I had more bloods done which showed my levels had gone back up slightly, but not by much.

I am back for more bloods tomorrow and I’m quite keen to stick with expectant management if I can, although I know it’s going to be a long and tough road.

I know the amount of time this can take is totally individual but I wondered if anyone has successfully done this?

Sending so much love to everyone going through or who has gone through this x

2

Dear Cerise,

I am so sorry to hear of your ectopic pregnancy loss,

Expectant management is a well recognised treatment method for ectopic pregnancy as it doesn’t have the same side effects as the methotrexate injection and isn’t as invasive as surgery. It cannot be used however if hCG levels are high or there is any sign of bleeding into the tummy. Ectopic pregnancies generally need to be diagnosed early for this method of treatment which is why it may not be so common. It is also difficult to predict how long it will take for hCG levels to get to pre-pregnancy levels with expectant management.

It is good to hear that you are having close monitoring and the medical team are keeping a close eye on your hCG levels and I hope they begin to fall soon.

It maybe comforting to know that there is no difference in the rates of conceiving again naturally between the three different treatment methods (expectant management, methotrexate injection of surgery) and 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years.

I hope this helps, we will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

3

Hello :slight_smile:

I had expectant management for my ectopic

It all went fine. I was a bit worried that it would mean the tube would be damaged and scarred, but had an HSG as a follow up which showed clear tubes. So I think it was a good course of action for me.

I am having trouble conceiving our first child still but this may or may not be related to the ectopic and expectant management.

Xx

4

Glad to hear that things worked out for you and fingers crossed that you’ll have some happy news soon!

If you don’t mind me asking, how long did the process take all in all? I’m currently a week in and hCG levels are creeping up but still not by much so I’ve been advised to stick with it for now. Quite nervous about the thought of it taking months for my levels to drop, especially as today they discovered quite a bit of bleeding around the site (which they said isn’t too concerning for now) x

5

Hi CeriseC,

I’m so sorry you had to go through this! I hope all is well now. I am currently experiencing what they think could be an ectopic pregnancy. I went in for a vaginal ultrasound yesterday which did not show anything in my uterus and they could not see anything in my tube as of now. However, my HCG keeps rising 27,33,55,126,280. They want me to wait until this Friday to get my HCG taken again and then go in for a repeat scan on Monday. I’ve had pretty heavy bleeding and cramping the last 3 days. I am curious how this resolved for you? Did you continue with expectant management?

6

Hi Sallyew13,

Do you happen to remember your HCG levels and timeline? I know that everyone is different but I find some reassurance hearing others experience especially with a somewhat positive outcome like you had.

7

Hi!

Funnily enough I was looking back at my hospital letters a few days ago and one of them has my hcg progression on it. Mine went:
87
77
92
115
88
33
2

This was over the course of about 2 weeks. I then had an ultrasound 2 weeks after my last hcg draw and there was no obvious residual pregnancy there. Also worth saying when my hcg rose twice in a row I had a scan and was basically prepped for surgery! It was only when a second consultant suggested that I wait it out as my numbers were so low, that I decided to give it a few more days.

I think I was super lucky as the whole process was fairly quick and painless. It was of course more mentally draining than anything!

Sorry you’re going through this. I hope it resolves itself and if it doesn’t l, I hope the process is as smooth as these things can be xx

8

Hello I’m so sorry for the delay. Only just alerted to the replies here. Here was my timeline:

29.08.23 - 265
31.08.23 - 428
03.09.23- 272
05.09.23- 111
09.09.23- 18
19.09.23- less than 4
Discharged on 19 sept

9

C bear,
Have you had any news
Take care xx

10

Cerise C
Can I ask if you managed to conceive at all afterwards
We still haven’t conceived and are starting IVF soon! Eek

11

We have only started trying this month (after being told to wait 3 months) so no news just yet.

Do you have any children already? We have a 3 year old so it’s frustrating that things are more complicated this time around but still very grateful.

Good luck with whatever route you go down. I hope you get your happy ending very soon x

12

Hi again @Sallyew13 @cbear25

Just thought I’d come back to this thread as I always found comfort in reading positive outcomes when I was going through this.

Shortly after my last message I found out I am pregnant again! EPU booked me in for an early scan around 5 weeks where they saw a gestational sac and small fetal pole in my uterus which was a huge relief.

They asked me to come back again 2 weeks later for a scan, and thankfully we saw a heartbeat 🩷 I’m around 8 weeks now and hoping everything goes smoothly. The worry is always there but feeling much more optimistic as time passes.

I hope you get some positive news soon and I also hope my story gives hope to those going through this xx

13

Hi CeriseC,

Firstly, thank you for sharing your experience, I have been reading through this forum looking for similar experiences to mine for comfort and yours reads pretty similar to what I experienced.

I also had expectant management and my HCG levels were 6 on Thursday 5th December and I am due for a ultrasound scan tomorrow to see what the situation is with the mass they found in my left tube.

Can I ask, when your HCG levels were falling, did you have any symptoms such as bloating/feeling of trapped wind around the abdominal area?

What were your symptoms when your HCG reached 0?

My initial ultrasound showed some free fluid around the site of the mass but nothing they were worried about. However,as I feel like I am experiencing bloating/stomach ache am worried it could be linked to bleeding around the site.

Anyway, Did you have any follow up scans/tests before you started to conceive again?

I’m so happy to hear of your successful pregnancy :purple_heart: Again, having gone through a similar experience to you of firstly a MMC and then an ectopic, it gives me hope.

14

Dear Cerise,
Congratulations on your pregnancy and thank you so much for taking the time to post about your experience. As you can already see, it really does give hope to so many.
Wishing you a smooth pregnancy,
Karen x

15

Hi @CLester

Sorry you are going through this but hopefully the end is in sight!

I can’t remember having too many noticeable symptoms but similarly to you, I had free fluid around the area. This actually concerned one consultant who advised surgery, however on second opinion it was deemed not to be too much of a problem and did resolve. I did also have some on and off spotting.

I was scanned 2 weeks after my hcg hit 0 to check for any residual mass and thankfully there was nothing found, which I guess means it reabsorbed/moved fairly quickly. I had read that sometimes the mass can take longer to completely clear, which is completely normal and usually resolves by the 3 month wait that they advise before ttc again.

Best of luck with everything and sending positive vibes to you, I’m sure you will get your happy ending very soon. It’s definitely possible! Xx

16

Hi all, I came across this thread and just want to say thank you for it as it really relates to my situation and also gives me hope for afterwards!

I was told on Monday this week I was having an ectopic pregnancy and admitted to hospital as they were concerned about some fluid. My hcg was 880 at that point. I was given all the options but was told by a lovely doctor to give my body a chance first, which I’m so thankful she did as I repeated blood tests and hit 653 on Wednesday (super backwards to think like that but hey ho!). A further blood test on Friday showed my results dropping to 331 which is a good sign. Have to go back in a week to see where I’m at.

I was thinking about doing the test for the fallopian tubes and seeing if there were any blockages after this, but how long did you wait? My nurse also told me I could start trying again as soon as my hcg is back to normal.

Thanks again everyone!

17

Hi @alice.rt

Sorry to hear you’re going through this, it’s really rubbish :frowning:

Sounds like your HCG levels are dropping at a good rate so hopefully your body will do its thing. The waiting and hoping can be stressful but o was definitely relieved that I was able to avoid surgery (Although apparently no difference in chance of recurrence with either option!)

So, I didn’t actually have a full check of my tubes after this. I had an ultrasound a couple of weeks after my hcg went to 0 to check if there was any obvious residual mass in the tube and it looked clear. Not sure that this can actually capture blockages or scar tissue though.

I was told to wait 3 months to start ttc again but there are mixed messages about this online. I think it’s to do with potential blockages and scarring and perhaps having a greater chance of another ectopic, but not sure!

Best of luck with everything! I hope you get some happy news soon. I’m currently 15 weeks and pregnancy looking good and healthy so far 🩷 x

18

Dear Alice,
As a gentle reminder regarding conceiving again, we and many medical professionals advise waiting for two menstrual cycles. It is important to allow time for your body to recover and emotions to surface and be worked through. This is so that you have some comfort that your body is returning to its natural rhythm and you have a last menstrual period date from which to date a new pregnancy - key information in checking you are not suffering from an ectopic pregnancy in the future. The first bleed soon after surgery for ectopic pregnancy is not classed as a period as it is a response to falling hormone levels.
We have more information on our website here
https://ectopic.org.uk/physical-recovery/trying-to-conceive-again

Sending much love,
Karen x