Dear E,
I am so sorry to hear of your ectopic pregnancy and loss,
I have copied this information from our website
The question regarding contraception presents a considerable dilemma at some point in life for almost all post-ectopic women because of their increased risk of ectopic pregnancy and the risks associated with some contraceptive methods. With all contraception, you and the prescribing clinician need to ask the same question – Do the benefits of this to the individual outweigh the risk? Doing this means that you can decide upon the most suitable method of contraception for you as an individual and it might be that you decide on one of the methods which is usually advised against. The issue really is about what suits you and how much you need to prevent pregnancy.
For women with a history of ectopic pregnancy, unless the risk outweighs the potential benefits, we suggest that the barrier methods (cap, condom, diaphragm, femidom), the combined oral contraceptive or Natural Family Planning are the most suitable alternatives for contraception.
IUDs (Intra Uterine Device) or coils are not recommended for those who have suffered an ectopic pregnancy as they are renowned for preventing pregnancy in the uterus but are not effective in preventing pregnancy elsewhere. With a coil in place, the sperm and egg can still meet in the fallopian tube and fertilisation can, and often does, take place. When things then progress as they should and the egg arrives in the uterus, the coil makes it a ‘hostile’ place and so conception does not continue because implantation cannot happen. The egg expires and is passed in normal menstrual blood (you can’t see it as it’s smaller than a pinprick and is not visible to the naked eye).
If a woman has suffered an ectopic pregnancy she has indicated that there was damage to the tube that was affected and there could therefore be damage to the remaining tube. The problem with a coil is that, if you have a damaged tube(s) and the fertilised egg gets stuck, the fallopian tube will temporarily be an environment where implantation can take place (although it shouldn’t) and it can result in a subsequent tubal ectopic pregnancy.
A Mirena coil is thought to be more suitable than other coils because it releases a small dose of progesterone, preventing ovulation in many instances. Unfortunately, it is not fool proof, and women do become pregnant with a Mirena in situ. You would need to discuss your suitability for this with your doctor though as a Mirena coil is a progesterone only contraceptive.
Progesterone Only Contraceptives (POCs), including contraceptive implants, the mini-pill or progesterone only pill, contraceptive injections and the Mirena Coil are associated with a higher incidence of ectopic pregnancy.
In control groups, women on the combined oral contraceptive were no more likely to suffer ectopic pregnancy, when they stopped taking it, than women who were not on the pill in the first place, thus suggesting that the oral combined contraceptive pill is NOT linked to ectopic pregnancy. However, there was a noted increase in the rate of women who suffered ectopic pregnancy if they became pregnant whilst taking the progesterone only contraceptive pill and it is now listed as one of the precautions in the product data. Likewise, the morning after emergency contraceptive pill is now available as a progesterone only pill and there is an increased risk of ectopic pregnancy with this form of contraception. Again this is noted in the product data.
I would advise talking through your contraceptive options with your GP or family planning specialist.
Sending much love,
Karen x
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