Discomfort after expectant management

Hello everyone hope you’re all aswell as can be…

I received my blood results today and the HCG level was negative so it pretty much only took just over a week to resolve however I am still feeling a bit crampy especially on the side the ectopic was found should I be concerned??? My EPU have discharged me from their care and didn’t offer a follow up scan which would of give me full reassurance. I have no bleeding or discharge that resolved the other day…

Any advice would be amazing

Thank you xx

Dear Kmw-89,

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

It is normal to experience some aches and pains following ectopic pregnancy as your body has been through a great deal. If your hCG level is negative, you are no longer at risk of rupture so it will just be everything settling down.

Unfortunately I am not medically trained so if you remain concerned, please seek medical advice as they should be able to out your mind at rest.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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


During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

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


Thank you so much for your reply Karen much appreciated… I am mentally drained I am worried about my fertility I have asked for a hsg test and was refused they told me they can only do this if I am unsuccessful again. All the EPU said was that as my levels are negative the pregnancy has completely gone but I am really anxious and scared something might still be stuck in there… i no the embryo has completely gone as the lady whom did the other scan told me it wasn’t there anymore and it was just the rest that needed to come out. I was really expecting things to take a lot longer than this… would you say it’s a positive that my body cleared everything so quickly?? Xx

Dear Kmw-89,

Not knowing what is happening to our bodies can be extremely overwhelming and you have a friend here who understands.

In the UK, women aren’t routinely offered further testing or scans following ectopic pregnancy. If the sonographer couldn’t see any blockage in your tube on your last scan, I would take that as positive news.

The wait for 2 periods before trying to conceive is also important as it gives time for our bodies to recover.

The key to remember is to have an early pregnancy scan in any subsequent pregnancies. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

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


During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

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


Hi. I was diagnosed with an ectopic pregnancy on the 9th of December and was management by expectant management. My hCG levels dropped by early January and I have had a negative home pregnancy test and a period since then. I still have twinges of pain on the side of my ectopic. Nothing major. It’s not severe and doesn’t last long but is definitely still there. I think some pain is usual for a little while after. You are still in the early days of recovery so remember to be kind to yourself x

@Kmw-89 @lolly2481 how long did your pain last in the end? I too have just been through this. Diagnosed at 6 weeks pregnant with HCG at 218 and advised expectant management. Took 6 weeks for HCG to drop to 22 and EPU discharged me. Today’s 2 weeks after being discharged, I’ve had a period bleed, but my at-home urine pregnancy test still has a VERY faint positive line (I guess HCG still present, but line much lighter so probably lower than 22) and I still have consistent pain. I’d say the pain is not severe or concerning to the point I’d go to A&E, but it’s stubbornly there that I don’t feel comfortable going for a bike ride or running or do anything strenuous. I can also feel it if I put a little bit of pressure on my abdomen, either by sitting down quickly or by pressing on the left side (it was in my left tube), so that’s certainly not normal. I’m eager to know how much longer it might take for the pain to fade away so I feel like normal again. I can’t find many successful expectant management stories out there, only lots of discussion around methotrexate and surgery, which seems to have a very different timeline and pace of recovery. I’d be really grateful to hear from you what happened to you in the end and how long it took you to recover.

Hello lovely wow this seems like a life time ago I wrote this tread..

I cannot remember exactly how much longer you will experience the pain but I did unfortunately have a second ectopic roughly 2 months later (April) same tube ( right) and expectant management treatment was done again which was successful. I do from time to time experience the odd bit of pain during ovulation.

Onto the successful story as like you I couldn’t find many..

I was referred to have an investigation of my reproductive system and possible right tube removal thankfully during my lap/dye and hysteroscopy which was done in the October (6 months after my second ectopic) everything came back completely clear even my tubes were completely clear so no need for my right tube to be removed I was completely shocked.

Then December (around Christmas time
of the same year so 2 months later) I fell pregnant with my daughter and she now a feisty 2 and half year old who is currently running around and dancing to baby shark.

Obviously I will never get any closure to why it happened as we do not and will never no the reason I will always remember my 2 angel babies that I lost in January & april 2021 however i was extremely fortunate to of had my daughter the following year.

I really hope this gives you some comfort and hope. I honestly thought I would never conceive again let alone the same year I went through those traumatic experiences my daughter is living proof that success can come out of this.

Wishing you all the best in your journey xx

Sorry I didn’t tag you x

@Kmw-89 Thank you so much for taking your time to reply and tell me your story. It means a lot and it is so very comforting to hear. I’m still feeling some pain on the affected side, so my GP referred me back to EPU for another blood test yesterday, but they found HCG has dropped to 2, so pretty much 0. They also gave me another regular ultrasound and said the ectopic “mass” is still visible and stayed pretty much the same size, although it has changed its appearance a bit and became less defined, so it’s probably in the process of resolving itself, although slowly (it has been 6 weeks since diagnosis at 6 week pregnant). I’m guessing the pain might be coming from the “mass” / scar tissue / residual inactive tissue or whatever resolving itself, but I just don’t know how long it’ll take to go away. Same as in your case, they don’t normally offer HSG or HyCoSy unless it is for somebody with recurring ectopic or for somebody with more complicated problems, so they just discharged me because it is my first ectopic (and my first pregnancy ever), and they don’t see anything else wrong with me. I’m really eager to try again as I’m not exactly young, but somehow I feel it’s a bad idea to try again too soon. I might wait a few months… Do you remember how big your ectopic pregnancy measured when they first discovered it on ultrasound? I’m asking because I wonder if it is even possible for my mass to disappear like yours given no medical intervention. I know everybody is different but your case sounds more similar to mine comparing to most other cases I’ve read. Again, thank you so much for sharing your story and it’s been so helpful mentally to just have someone to talk to who has gone through similar.

Hey Joannad,

I just saw this thread and thought I’d reply with hopefully some helpful insight! I had an ectopic back in January and treated by expectant management as well. My levels were 890 and think it took about 3 ish weeks to drop down to negative levels (I was discharged when it was at 4).

I’m not sure what my ectopic mass was as I honestly barely remember that conversation, but I’ve had two periods since everything happened and decided to book an ultrasound scan myself a few weeks ago where they saw no mass etc. So I can imagine it takes a few months to go which is why we get recommended to wait a few months before trying again.

As of today, I still feel slight pain from time to time (more so around ovulation and period), not severe and only lasts a few seconds but I think with everything that has happened it’s normal to be very hyper aware of our bodies, when usually we wouldn’t even think about it!

Hope this helps and you’re doing okay.

No problem at all if I remember correctly the first loss was roughly 2cm when I found out I was roughly week 6 according to my LMP so I was already in the stages of passing I also remember each time I passed urine I would get a awful pain this is what kinda prompt me to do a test and my mouth tasted like pennies.

I was told due to only having the management treatment I could try again after 2 cycles which I did then hello round 2 I found this one much earlier as I was tracking my ovulation and so did the pregnancy test I think it was 16 days after ovulation. The mass was tiny on the scan I actually started bleeding 8 days after I got my positive.

I knew in my heart something was off the second time round I had the shoulder pain which was intermittent and my lower back was so painful kinda like period pains i had a gut feeling so when I went for the scan I was shocked.

It’s so odd as I have 2 children already prior to my daughter they’re older my son is almost 14 and my other son is almost 12 huge age gap between my 2 boys and daughter so I really didn’t think I wanted anymore babies however the experience of my losses made me realise I wasn’t completely done. I never had any conception issues with my boys at all but I was much younger in my early 20s

Definitely opt for any investigations lap and dye etc my gp were amazing they actually referred me back to the specialist who I was actually booked in for an endometriosis investigation op literally 10 days before I found out I was pregnant with my first ectopic yes I am one of those women who manage to get pregnant prior to an operation I sore that would never be me :see_no_evil_monkey: my specialist was actually private but take on nhs cases I was quite shocked as I didn’t realise private hospitals take on nhs cases.

The hardest part is no one can ever explain why this happened it will always be inconclusive due to everything coming back healthy and clear.

Keep fighting I did and now I have my little girl positives do come out of this you will be in a dark tunnel for sometime but light will shine through very soon I always think of my little losses I promise it will get easier xx