Help, could I be pregnant even after surgery?

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Hi,

I realise this is a very unlikely and confusing question.

I am 34 and had surgery to remove an ectopic pregnancy and my right tube just under 2 weeks ago. I already have one beautiful son age 3, but suffered a ‘straightforward’ miscarriage at 10 weeks while trying for our second baby in Nov 2015. We were quite put off trying again for a while after that experience as it was so upsetting and physically draining, but felt ready and started trying again in September 2016. I was already starting to feel disheartened after a couple of months and a bit worried about fertility. After Christmas I felt some early pregnancy symptoms but on Jan 11th 2017 I had a negative pregnancy test, and the next day my period started on the exprected day. It was fairly light but not unusually so and only lasted 2-3days but again this is not unusual for me. We started to ‘try’ again soon after my period finished but around a week 10 days later I began to feel very tired and under the weather. The GP diagnosed a mild uti, antibiotics and I said there was no point her doing a pregnancy test as I’d had a negative one and a period only a week or so ago. The next day I felt very ill abc collapsed. To cut a long story short, a few days later this was then to my shock diagnosed as an ectopic pregnancy with estimates that I was around 6 weeks pregnant. I had to have emergency surgery to remove it abd the tube as there was a significant amount of internal bleeding.

My main question now is - could I be pregnant from the sex we had between the negative pregnancy test and the surgery?! (I have obviously not had sex since!) As the pregnancy hormone must have been low to have a negative test, could I have ovulated again and conceived?! I know this is a bit of a silly question but everything seems very confused and the dates confuse me. One week after the op I began bleeding quite heavily for around a week. I’m also having twinges of pain on my left side, although my right tube was removed. I’m also worried about preserving my remaining tube, as it looked healthy from the outside and as I had had two previous ‘normal’ pregnancies I am assuming my tubes weren’t blocked or damaged. Is there anything I can do?

Thanks for reading!

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Dear Sarahvw,

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

Unfortunately I am not medically trained so cannot comment on your specific queries but as I understand it, you no longer ovulate once you become pregnant and if you had a twin pregnancy, they would have seen evidence of this during your scan.

Experiencing some pain after an ectopic pregnancy is normal as your body has been through a great deal over the last few weeks. The pain may be due to adhesions (scar tissue that binds two parts of the body together) which form and take some time to settle. Your body may be preparing to ovulate and many women experience ovulation pain when they did not before their ectopic pregnancy - including myself. You also may have a heightened perception because of the sad loss that you have had to go through. If you find you experience offensive smelling discharge or an increased temperature of more than 37°C or just want to be checked out to be on the safe side, it would be worth asking your doctors to run tests to check for infection.

I completely understand your worries about a further ectopic pregnancy, but sadly nothing can be done to prevent ectopic pregnancy. 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.

Generally the chances of a further ectopic after a first in UK is 10%. So thats 90% chance of the embryo being in right place next time.

Also, 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.

As a gentle reminder, we and many medical professionals advise waiting at least two menstrual cycles before trying to conceive again.

Please note that the first bleed after an ectopic pregnancy, is not classed as a period - it is the body’s response to falling hormone levels as you are sadly no longer pregnant and shedding of the uterine lining that had build up which involves bleeding.

This “wait” is to allow your cycles to resume and have a last menstrual period date from which to date a new pregnancy - important information for checking for ectopic pregnancy in the future. It also allows time for your emotions to surface and be worked through after your ordeal.

There is no time frame for how long it takes us to heal emotionally and it is completely normal to feel anxious about the future. We will never forget our pregnancy or babies but we can learn to accept what has happened and crucially understand that it wasn’t our fault.

We are here too. TTC emotional rollercoaster compounded by our sad loss. You are not alone, we are here for emotional support whenever you need us. There is also a specific TTC board you can look at too, whenever feel ready.

Sending much love,

Karen x

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

Further information is available at www.ectopic.org.uk

Email us at ept@ectopic.org.uk.

Our helpline is 020 7733 2653 (available Monday to Friday 10am - 4pm).

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.

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Thank you so much for your response Karen. I think I do need to take more time to recover and process everything. Thank you x