Hello,
I underwent ectopic pregnancy operation on 20/04/2017. Right tube was removed. Was trying to conceive since 01/07/2017. Had per-investigations done again and underwent HSG test on 30/05/2018. The remaining left tube was found normal and patent. Now got pregnant the same cycle and tested positive on 26/06/2018. Have scheduled a early scan on 06/07/2018 which is 6 week and 3 days post the last period date. I have two questions: 1) Is the early scan we scheduled is on the right time to rule out another ectopic? 2) What are the percentage of chances of another ectopic after successfull HSG test on the remaining left tube?
Dear jagjitshukla,
Whispered congratulations on your pregnancy.
To answer your question, yes your scan is booked for the correct time, we also advise to have an early pregnancy scan at 6 weeks, this is because there is a reasonable chance of seeing an embryo at this time.
I am unsure of data that give details of percentages of successful pregnancies following HSG testing, however 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 this time.
Sending much love and positive thoughts,
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.
Hello,
I have started bleeding sometimes brown and some times redish brown discharge since past 4 days. The discharge is not enough to fill the pad. But every time i wipe the tissue when i go for pee it is there. Went to A&E department and requested early scan. Scan was performed yesterday but they could not find any sac inside the uterus (by dates i was 6 wk pregnant yesterday). They have taken one blood sample yesterday and would take another tomorrow (48hrs apart) and let us know the outcome. Currently there is no pain on the lower side of the abdomen. The pain some times is only below the belly bottom. Waiting from some thoughts from the forum…of the result
I’m having spotting too. My HCG is only 300 so they said they couldn’t give me a scan because it they said it wouldnt show anything till my HCG is 900. So I have to go back in 3 days to see if the number have tripled. I’m having the same spotting as you described. Please keep up updated on what has happen.
Dear ladies,
I am so sorry to hear of the worrying time you are going through,
If scans are inconclusive, doctors would carry out a series of blood tests to check hCG levels to see if the numbers are rising as expected. However, in isolation, hCG tests only provide a part of the picture - declining levels indicate that a pregnancy has ended and will be miscarried. It can also possibly indicate an ectopic pregnancy that is “self-resolving”. Also hCG levels rising by less than 66% over 48 hours means it is likely (but not certain) that it is ectopic. If levels rise normally, they suggest the pregnancy is implanted in the uterus. You may see from this that hCG levels only indicate certain possibilities and are not in themselves a definitive guide. A positive identification of an implanted embryo on a scan is usually needed before a final diagnosis/certainty that the pregnancy has implanted in the uterus. This is possibly the reason why your doctors are waiting to carry out further scans and tests.
Am thinking of you both, sending positive thoughts and 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.
Hi,
Went back for a scan and nothing in the uterus. They found some mass near the ovary which could be ectopic. HCG level is going down. The three consecutive readings were 981, 1450, 1350. Asked to wait for two days before oral medication treatment. Is this the case of “self resolving” ectopic? Since HCG levels is going down is it necessary to take Metho treatment? Should we employ wait and watch approach and if so how much time typically it takes for HCG level to go down to zero in such cases given current value above? Waiting for some positive thoughts…
Dear jagjitshukla,
I am so sorry to hear this news,
If scans are inconclusive, doctors would carry out a series of blood tests to check hCG levels to see if the numbers are rising as expected. However, in isolation, hCG tests only provide a part of the picture - declining levels indicate that a pregnancy has ended and will be miscarried. It can also possibly indicate an ectopic pregnancy that is “self-resolving”. Also hCG levels rising by less than 66% over 48 hours means it is likely (but not certain) that it is ectopic. If levels rise normally, they suggest the pregnancy is implanted in the uterus. You may see from this that hCG levels only indicate certain possibilities and are not in themselves a definitive guide. A positive identification of an implanted embryo on a scan is usually needed before a final diagnosis/certainty that the pregnancy has implanted in the uterus. This is possibly the reason why your doctors are waiting until your appointment to carry out scans and tests.
Treatment is decided upon individual circumstances and include how high your hCG levels are and other factors such scans showing fluid in your abdomen and I would discuss all options with your Dr. We have more information about different treatments here-
https://www.ectopic.org.uk/patients/treatment/
We are all hear for you for as long as you need,
Sending much love and warm hugs,
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.
Hi
Did blood work again and to complete the HCG serial values they are: 981, 1450, 734, and 354. Scan was performed 24hrs after the peak value and nothing was found in the uterus. Different posts suggest that hcg value of between 1500 and 2000 is required to see the gestational sac. We never reached this value on the scan day. And now the hcg levels are falling at rough 50% rate every 48 hrs. So the question is whether it is a case of miscarriage or ectopic pregnancy? Can we judge if the failing pregnancy was intrauterine or ectopic based on the rate at which the hcg levels fall?
Dear jagjitshukla,
I am so sorry to hear that you are continuing to go through a difficult time.
To give a brief overview, if no pregnancy can be seen in the uterus, or there is a small gestation sac in the uterus without a yolk sac or embryo, the pregnancy will be medically labelled as a Pregnancy of Unknown Location or PUL. It is important to understand that PUL is not a diagnosis; it is a label given until the final location of the pregnancy can be identified with certainty. In the event of a PUL, blood will be taken to measure serum progesterone and hCG and the hCG test repeated 48 hours later. The doctors would also want to repeat the scan.
Until the location of the pregnancy is known definitively or the serum hormone levels have decreased to below pregnancy levels, there is a risk of complications associated with an as yet undiagnosed ectopic pregnancy. For every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic; and not all of these will need treatment.
If no pregnancy can be seen in the uterus but there is evidence of free fluid in your abdomen and or a possible ‘mass’ in the approximate location of one of your fallopian tubes, the doctor would then be likely to diagnose a possible ectopic pregnancy. An initial scan will detect over 70% of ectopic pregnancies, but as you can see, it is difficult to give you a diagnosis.
Not knowing what is happening to our bodies can be extremely overwhelming and you have friends here who understand. We would gently remind you to not undertake any strenuous exercise or lifting or housework while your hCG levels are dropping. While I do not want to alarm you, there remains the risk of rupture even with low or declining hCG levels. You should not resume exercise until your hCG levels are falling consistently and are in the low 100s.
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.
Hello,
Would like to update that as of 17 Aug 2018 my HCG levels have now reached zero on its own (without any treatment - self resolved). I tested using pregnancy test kit. So it roughly took two months from the initial start of bleeding for the hcg levels to go the zero. We were not able to confirm the exact location of the pregnancy except that the second scan showed a possible mass adjacent and medial to the left ovary. Since there was no tube rupture, is it possible that the embryo was outside the tube or at the fimbrial end? And now since we know that it has self resolved, can we start ttc naturally again or should we go for ivf straightaway given that this was second ectopic? I am now 39 years old. please give your thoughts…