Ectopic resolved with expectant management

Preparing For Your Next Pregnancy
1

Hi everyone,

Today, I had my last EPU appointment - my 6 weeks follow up after ectopic treatment.

I was diagnosed with an ectopic/PUL pregnancy last March. I was treated with expectant management (despite medical advice suggesting surgery due to pain and anxiety… a bit of a long story) and my HCG hit 0 at the start of April.

I bled for 2-3 days when my HCG was down to 32. I continued to have pelvic pain on my ectopic side and occasionally on my non ectopic side. But the frequency decreased with time. 5 weeks later, I had my first period.

Today, on my appointment, I was scanned again. I didn’t expect that as I know some women didn’t have a final scan because some doctors don’t think it is necessary. Every thing was clear in the scan except for a tiny fibroid. The mass was no longer visible and it looked like I am about to ovulate on my non ectopic side. My doctor did say that she’ll never be able to say for certain if it definitely was an ectopic vs something else because only an exploratory laparoscopy would’ve been able to confirm. But because I knew that it could lead to me losing my tube, I declined that procedure. During the appointment, I tried to ask as many questions as I could but I already knew all the answers:

When can I safely start again? The advice is to wait for 3 months.

What caused my ectopic since I have none of the risk factors (apart maybe age)? Sometimes, there is no cause and for me, it appears to be just my luck (bad luck).

There was a cyst found in my first scan. Could it have caused the ectopic? No

Could I have caught chlamydia or something leading to pelvic inflammatory disease without knowing? Very unlikely because if I had pelvic inflammatory disease to the point it caused loads of scarring, I would’ve known. The only way to diagnose pelvic inflammatory disease would be to do a laparoscopy.

My doctor and nurse were lovely. They advised me to call them as soon as I find out I’m pregnant again for an early scan. My doctor did say that I am now at higher risk of another ectopic but reassured me by saying that she has worked with many women who went on to have a healthy pregnancy. They both wished me good luck and hoped to see me again with good news.

I left feeling like I could finally turn the page on the most difficult chapter of my life so far. I know it’s not over yet as I will still have a wobble. I am still struggling to see pregnant women or women with young babies without feeling resentment or anger or just sadness. I am still terrified of the idea of trying again. And I don’t know how I’ll feel in November, when my due date would’ve been. But I am starting therapy tomorrow and hopefully it will be the start of a chapter full of hope.

Sorry for another long post. This forum and EPT helped me so much. And I am hoping that my story can help other women through their own journey. Thank you for being there when I needed it the most!

2

Hi Lyn_K,

Thank you for sharing the resolution of your story with us. I’m so happy that you have come to this point and that your care was so supportive. I know that this is not the end of the journey, and we will continue to be here for you whenever you need us. Be well and please take good care of yourself.

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

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

3

Hi,

I also got the all clear on Friday. It’s a strange moment, isn’t it? I am relieved that the hospital trips are over, and I know we had to get to this point to think about moving forward, but it is also really sad to draw that line.

You asked about trying again - I’ve read conflicting advice about this but our nurses advised we can ttc straight away. It’s another thing I feel really mixed about though - how about you? I am desperate for a baby and I’m 37 - with 38 just round the corner - so time is not on my side and we don’t want to wait to try again, but it is also terrifying to think about going all through this again.

Sian

4

Dear Sian,

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

It is normal to feel anxious about the future. We experience a mix of emotions from wanting to try again to being petrified of what may lie ahead. We never forget but we can learn to accept what happened. It is a slow process that might be weeks or months ahead. In time, we can get to a place where we feel comfortable trying again. When this is, is individual for each person. There is no timeframe for recovery, take each day as it comes.

Importantly early scans avail. 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.

The chances of a further ectopic after a first in UK is 10%. So that’s 90% chance of the embryo being in right place next time.

While generally it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 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 am not sure what treatment you had for your ectopic pregnancy, I’m guessing expectant management. I don’t want to give you incorrect information regarding trying to conceive as it will differ on the treatment you’ve had, so I have added the information from our website which I hope you will find useful.

https://ectopic.org.uk/physical-recover … eive-again

Making the decision to begin trying to conceive is an emotional rollercoaster compounded by our sad loss. Again, you are not alone. We here emotional support whenever you need us.

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

5

Thanks Michele for the kind words. And thanks Karen for the information.

Hi Sian,

I am sorry for your loss. But I am glad you got the clear. It was also a strange moment for me: kind of relieved that all the visits, constant fear and blood draws were over but at the same time it was accepting that I was no longer pregnant. I know my baby wouldn’t have survived and I could’ve lost my life but I still felt sad. And at the same time, you are left with the feeling of ‘what’s next?’

I am 36 and turning 37 in a few months. So I am on the same boat, racing against time. I also read many conflicting information about when to start trying again after expectant management. But I think what the EPT says makes the most sense. I know that the mass is now gone but I imagine that my tube might still be inflamed and still recovering. I want to allow it the time it needs to heal properly because if there is any left over inflammation or scar tissue not yet reabsorbed and not picked up by the scan, the chances of another ectopic would probably be higher than 10-15%. My thinking is if waiting for another month means that my chances of another ectopic is lower, I’d rather wait that extra month. And if I choose not to wait and have another ectopic, then it’ll be another few weeks of treatment and another 3 months on top of waiting for everything to heal, mentally and physically. Obviously, this thinking isn’t backed up by research. And waiting vs not waiting can still not guarantee a healthy pregnancy. But that’s how I reason it in my head and I hope it makes sense.

I hope this helps. Good luck with TTC xx