PUL and ovarian cysts

Main Board
1

Hello,

I was diagnosed with a pregnancy of unknown location in the middle of Feb 21. I had 2 doses of methotrexate and my hcg levels have been falling over the past few weeks. 2 weeks ago my level was 34, so I knew I was nearing the end of my experience. Throughout this time I had no pain or bleeding.

However, a few days later, I experienced some intense pain in my right hand side, which made me worried about a rupture. I went to EPAU and an internal scan showed I had a large ruptured ovarian cyst which was actively bleeding and pooling in my pelvis. I was taken for surgery and the bleeding was cauterised, then I was discharged. I rang EPAU to see if I needed another appointment, they advised me that my bloods taken whilst in hospital showed my hcg was 19 so they didn’t need to see me anymore.

I’ve never had any gyne problems in the past, I have a healthy 2 year old conceived naturally prior to this recent PUL.

I just wondered if anyone had a similar experience or words of wisdom, as now I’m starting to wonder if I have some undiagnosed gyne problem which has caused the PUL and ovarian cyst?

Thanks so much

Natalie x

2

Dear Natalie,

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

Sadly I am not medically trained so cannot give you specific advice on your queries, I presume from the post that the ovarian cyst was that and not where the ectopic pregnancy was diagnosed. This sounds like terribly bad luck if so.

Unfortunately many women do not find a reason as to why they have experienced an ectopic pregnancy 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 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.

Importantly, help is available if conceiving naturally has not yet been successful after some time trying - and the EPT advises that women under 35 should seek medical advice following 12 months trying to conceive and those over 35 should seek advice after 6 months.

In terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).

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.

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

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

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

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