Any successful expectant management stories?

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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

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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

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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

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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

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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?

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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.

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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
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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

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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

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C bear,
Have you had any news
Take care xx

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

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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