Fertility referrals

Preparing For Your Next Pregnancy
1

I was wondering if anyone has been referred on for fertility support, and what the process looks like? And how do you cope with the waiting?

I had my ectopic a year ago next month (Feb 2022), it ruptured and my right tube was removed.

I have other conditions such as endometriosis (although surgery to remove has been successful so far) adenomyosis, small ovaries and low (although the high end of the low) anti mullerian hormone levels.

I was told to start trying sooner as it may take me a while to conceive and if I hadn’t conceived with in a year I’d need referring to a fertility clinic. Ironically, we conceived the second try but it was ectopic, and now my chances have lowered more than ever.

I got referred to a fertility clinic in November and was told I’d receive an appointment by today (8 weeks later). I’ve just rang and they are 4-5 months delayed in referrals and giving out appointments.

We started trying again on the 1st May and it just isn’t happening. I get horrendous ovulation pain on the right side most months and I’ve read the the right is the dominate side for releasing eggs. I feel I probably don’t even have the chance to conceive every other month.

I just feel I’m trying to live my life and move forward but it’s hopeless and impossible. I’ve been doing really well and had a positive mindset but the thought of another 4 month wait for just receiving a date for an appointment is too much, I’m at a total loss. Has anyone been through this and how did they manage?

2

Dear Chloe,

I am so sorry to hear of your ectopic pregnancy loss and of the wait to be reviewed by a specialist. I know the BUS is under enormous pressure at the moment and I’m so sorry you are caught up in it all.

I wasn’t aware there was a dominant side of releasing of eggs and it isn’t strictly true that we ovulate from alternative ovaries each month either. It is true that you can get pregnant from the ovary on the side you had your surgery though. Generally, when a person has only one fallopian tube and both ovaries, they are still able to get pregnant from an egg at the opposite ovary as an egg from one ovary can travel down the tube on the other side. The fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae begin to move gently creating a slight vacuum to suck the egg toward the end of the tube it is nearest to (like lots of little fingers waving and drawing the egg towards it). So, if you have only one tube then there is only one set of receptors working and one set of fimbriae creating a vacuum and so the egg is much more likely to find its way to that tube, whichever ovary it is produced from. Conservative estimates suggest that an egg produced on the tubeless side manages to descend the remaining tube around 15 to 20% of the time.

I very much understand that strong desire to conceive. I appreciate how frustrating it can be if it isn’t happening as quickly as we would like. Conceiving successfully can take time and can take some couples more than a year or so.

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.

In addition, having regular sex means having sex every 2/3 days throughout the month. Guidance from the UK’s National Institute of Health and Clinical Excellence advises that having sex around the time when the woman ovulates causes stress and is not recommended. We here at the EPT suggest having intercourse 2/3 times between days 10-20 of their cycle when trying to conceive.

Sending much love,

Karen x

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