Dear Nat81,
I am so sorry to hear of your ectopic pregnancy and loss and continued pain.
Unfortunately I am not medically trained so cannot give you specific advice on your queries and would always advise speaking about your own personal situation with the medical team looking after you.
It maybe comforting to know that studies suggest the chances of pregnancy are about same irrespective of type of treatment - Expectant management or medical management or surgery.
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.
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.
I would certainly discuss timings of trying to conceive following two doses of methotrexate treatment with your medical team to find out why they have stated to wait for 6 months before ttc. Some doctors (mistakenly) think that because they have administered a second dose of Methotrexate that that they must also double the recovery time for the body. However, even in a second dose of Methotrexate, the dosage is still much lower than for treatment of other conditions and is still metabolised by the body very quickly.
Our medical advice is that, if you have had two injections, you should rely on your blood test results as an indicator of what is happening in your body and wait until your hCG levels have fallen to below 5mIU/mL in blood tests and then can restart taking vitamin/folic acid supplements for 12 weeks before you try to conceive. I would advise to check with your team to ensure there is no medical reason why they have advised 6 months in your case.
Following surgery to remove a tube, 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.
It is normal to feel anxious about the future. We experience a mix of emotions from wanting to try again to being petrified of what may lie ahead. We never forget out babies but we can learn to accept what happened. It is a slow process that might be weeks or months ahead. In time, we can get to a place where we feel comfortable trying again. When this is, is individual for each person. There is no timeframe for recovery, take each day as it comes.
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.
Ultimately it has to be a decision you are comfortable with, armed with the knowledge and support from your medical team. I would advise discussing all options with them to help you make a decision.
Sending much love and warm hugs,
Karen x
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