Concern about what is left after conservative management

Preparing For Your Next Pregnancy
1

Hello,

I am currently ovulating for the second time since suffering my ectopic. Each time I have had a persistent dull ache in the area where the pregnancy was (near the ovary but apparently in the tube on my right hand side). My HCG went down very quickly (probably as it has already been ending for some time before I was diagnosed. It was size of 6.5 week embryo when found at 8 weeks) and I was discharged from care and had no positive pregnancy test.

I’ve found it really hard to find any information out on what actually happens to the tissue and how long it takes to break down and be resorbed. In my mind, (especially given I have some mild pain there) the pregnancy tissue is probably still there, blocking the tube. I was told I could try again after one cycle due to my age (37) but we decided last night to wait the two cycles. I’m scared that my chances of it happening again are greater at the moment and I’m frustrated I have no idea what’s going on in there. If it’s still breaking down, surely that’s a risk? I wish I could have another scan.

We’ve been trying for over a year after suffering a miscarriage at 12 weeks in January in which I haemorrhaged. I’m not having much luck at avoiding life threatening pregnancies and this is affecting my enthusiasm for sex or trying again, even though it’s all I want in the world. I have one son, he’s my comfort.

Thank you

Kate

2

Hi Kate,

I’m so sorry to hear that you’ve suffered an ectopic pregnancy and loss. It is both an emotional and physical trauma and can leave us with many questions.

In regards to your situation and expectant management, the ‘reabsorption’ can take weeks and sometimes months to be complete and is monitored through beta hCG blood tests. It is true that in some instances, the fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink and, occasionally, it may not shrink and will leave a blockage in the tube by way of a small cyst. As far as I understand, ovarian cysts are very common, are usually harmless and often do not show any symptoms. Ovarian cysts do not normally affect fertility and most women who get a cyst find that it is usually small and will go away by itself. This type of cyst should not affect your ability to conceive.

It is important to give your body and yourself time to heal after an EP. The Trust advises couples to wait at least two full menstrual cycles or three months before trying to conceive again. This is to allow time for your body to heal and emotions to surface and be worked through. However, you can take all the time you need in the healing process.

While it’s important to know that an ectopic pregnancy is not preventable, there is nothing you did to cause the ectopic pregnancy and miscarriage to take place. The chances of an ectopic pregnancy in the UK after a first is around 10 per cent. With future pregnancies, it is possible to have early scans to ensure you have the right help in the beginning. It may provide some comfort to know that it is usually possible to conceive successfully after having an ectopic pregnancy, though the time it generally takes varies considerably from couple to couple. Approximately 65 per cent of women are healthily pregnant within 18 months of an ectopic pregnancy and some studies show this rises to around 85 per cent after two years.

We know that recovery is not a straightline, and we are here for you throughout.

With good wishes,

Michele

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

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