Expectant Management....no information anywhere

Preparing For Your Next Pregnancy
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Hello Everyone,

I feel so lost this week. EP was diagnosed 13 days ago I think under the circumstances I was lucky to be able to manage it with expectant management. My HCG has dropped to 0 already. It was checked on Tuesday. I had a bleed over the weekend, it started on Monday and finally tapered off Tuesday and seems to have stopped yesterday. I had the EP on my left side, it measured 1.5cm so it was only small. On the right side I had a cyst on my ovary measuring 2.7cm (I was originally told by a nurse it was 7cm but they got it wrong…just 2.7cm). Apparently this was bleeding into itself. I had a scan for diagnosis and then another a week ago…EP was all still there and the cyst was 2.5cm so it has shrunk a little. I had a cyst the month before I assume as I had the same pain…I think it’s coming up and down each month…no idea why! I’m frightened one tube has this EP in it and the other has the cyst… No further scans as I’ve been discharged and the 1.5cm EP will apparently be absorbed into the body. Asked when I could TTC again ‘give your body time to recover’ was the response…how long is that??? I’ve read that after Expectant Management some EP take up to 6 months to be absorbed into the body. Where as the advise for those who take the medical or surgical route is 2 cycles or 3 months, whichever comes sooner. Do we risk trying after 2/3 months or wait for 6. I’m 35 anyway so not in a position to mess around…my fertility will have already peaked and be on a decline now. But I don’t want a set back and to have an other EP which could have been preventable. Also worried about the cyst…if it’s just a cyst, will it prevent ov on that side? Feeling emotional, so along and worrying myself to oblivion. Thanks for reading.

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Hi Tibby99cat,

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

In regards to your situation and expectant management, when your hCG levels are fall below 5mIU/m you are then considered no longer pregnant. The ‘reabsorption’ can take weeks and sometimes months to be complete and is monitored through beta hCG blood tests. 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.

As the GPs advised, 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. As well, you can start taking folic acid now.

It’s also important to know that an EP is not preventable, and there is nothing you did to cause the EP 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.

As well, it’s important to continue communicating with your GP should you have any concerns about the cyst. You may consider keeping a diary of any pains associated with the cyst and any actions you have taken to alleviate pain.

These boards are a safe place for your questions, concerns, or just to vent. We are here for as long as you need.

With good wishes,

Michele

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Further information is available at http://www.ectopic.org.uk

Email us at ept@ectopic.org.uk.

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Thank you Michelle :slight_smile:

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Michelle, I just wanted to ask. My HCG is already 0… what does his mean? You mentioned with regards to the ectopic that it’s monitored through HCG blood work. As I’ve returned to 0, I’ve been discharged. Does this mean the pregnancy tissue will have ‘gone’? Or could it still take months? Thank you Michelle.

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Hi I requested a scan when my blood work was at 0 and the mass in my tube had gone so if your at 0 generally this means there is no more pregnancy in your body. Hope this helps x