How long for the sac to dissolve with expectant management?

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1

Hi all

I was managed expectantly which worked and my levels came down naturally until I got a negative pregnancy test. This was about two weeks ago. I had a little more discomfort very similar to the cramping pulling type feeling slightly to the right side of my belly button that I had during the treatment for the ectopic a few days ago which lasted a couple of days. That has gone now and I started my first period since the ectopic yesterday which has been more painful than a regular period. The cramps are similar to miscarriage pain but manageable. It sounds awful but as I had a miscarriage the cycle before my ectopic then the heavy bleeding to shed the ectopic a few weeks later I’m kind of used to the pain now. I was just wondering if anyone had expectant management and had a scan a few weeks after to see if the sac had dissolved? I have been told to wait two periods before trying again as there is most probably scarring and inflammation which needs to heal and also the emotional side of things to get over too. I feel like I just want to start trying again though and am so impatient but don’t want to risk it happening again. I guess I just want to know other people’s experiences and how long you left it to try again? I fell pregnant both times very quickly and easily which I guess is a good sign but obviously don’t know how quick my body will get back into things. I just want a baby so much and all my family around me around re due around the time I wouldve had my miacarriage baby and then ectopic baby. Thanks.

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Dear blinc,

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

In the UK, it is not common practice to have a scan once hCG levels have dropped to below 5<mIU/mL unless you present with other symptoms, in which case your doctors will undertake a reassessment.

The ‘reabsorption’ you refer to can take weeks and sometimes months to be complete. I am afraid it can be difficult to be precise because our bodies are all unique and we respond differently physiologically with what is happening. In some instances, the fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink.

Reassuringly though, 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.

Regarding your query, we and many medical professionals advise waiting at least two menstrual cycles before trying to conceive again - and this is the same with expectant management treatment too.

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.

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.

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. There is a specific TTC board you can look at too whenever feel ready.

Sending much love,

Karen x

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