Pregnancy hope after expectant management

I have been going through expectant management for the last 4 weeks. The nurses have never seen the pregnancy on scans but confirmed it being ectopic due to my hcg very slowly dropping and free fluid with a small clot/ mass near my ovary ( they couldn’t tell properly what it was)

I am very lucky that I have not needed surgery or methotrexate as my blood levels seem to be dropping on their own ( HCG at first scan - 165 , now at 10 ) , however I am very anxious to get pregnant again due to worrying that whatever caused this to happen is still there as no surgery has taken place to see what’s going on properly. The nurses have said they can’t tell why this happened as I have none of the risk factors and no history of infection/ pain.

Does anyone have any advice or success stories of pregnancy after expectant management ? I see a lot of posts on surgery but very little on this.

Thank you in advance x

Hi rs1995x,

I’m so sorry to hear that you have suffered this ectopic pregnancy and loss. While I’m not medically qualified to comment on your specific situation, I will do my best to help.

The Trust recommends waiting three months to conceive. While there is no clear, researched evidence on how long a couple should wait to try to conceive after having treatment for ectopic pregnancy, we and other medical professionals advise that it may be best to wait for at least three months or two full menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is not your first period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy. Physically, this timeframe is to allow your cycle to return to normal and for there to be a clear period to date a new pregnancy from. The date of the first day of the period is what is used to decide when to scan a new pregnancy; information that is invaluable in ensuring you are not suffering from another ectopic pregnancy.

What I can say is 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.

TTC after an ectopic pregnancy can be an anxious time for many women. I know how strong the desire to have a child can be, and I encourage you to be extra-compassionate with yourself during this time. So many of these processes are well outside of our control. It’s important to have the emotional and physical support you need during this time. Please know that we are here for you throughout your journey. Please take good care and look after yourself.

With good wishes,

Michele

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811 (England & Wales) SC053187 (Scotland)

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