Dear Melanie,
I am so sorry to hear of your ectopic pregnancy and loss and of the difficult time you have been through. From your own words, I can imagine how frightening it was and I’m so sorry you have had to go through all of this.
When we experience ectopic pregnancy we are suddenly faced with a life threatening emergency and it’s treatment, reduction in fertility, concerns about the future and the loss of our babies. Experiencing any one of these is an ordeal, putting them together is immense and your feelings are completely normal.
Experiencing an ectopic pregnancy is a huge ordeal and you are in the early stages of recovery. You should take it very easily for about six weeks after surgery. Your body will be using its energies to heal internally. It is normal to feel physically and emotionally exhausted during this time and please do be kind to yourself. Recovery can take time and some days will be better than others, one day you maybe ok and the next you maybe in discomfort or more emotional. This is perfectly usual and the healing process will go back and forth in this way for however long you need. It is important to listen to your body’s signals and pain and feeling tired are your body’s signs to tell you to rest. We suggest keeping a healthy balanced diet, drinking lots of water and resting. Once your wounds have healed, very gentle exercise such as a short walk can help, but please do take this slowly.
Surgery is an immense ordeal for the body to go through, and you have been through it twice. In general, after about six weeks you should be able to return to most jobs from a physical point of view. However, if your role involves manual handling, we suggest that it would be sensible to have a phased approach, gently building up to the usual extent of activity. I would suggest avoiding a rapid return to strenuous activities as it is important to build up strength after recovery.
A few options may be available depending on your role: might there be an opportunity to work reduced hours, increasing them slowly over a few weeks? Perhaps there are certain tasks that you could take on which may entail a change from your usual role or a series of reduced tasks initially? I am not sure whether this is appropriate in your circumstances, but is there anything that you could action from home (which may be different from your usual role but still be of use)?
In addition, it is worth bearing in mind that experiencing ectopic pregnancy is a very frightening experience and many women need to take time to help them deal with the psychological/emotional impact of the loss of their baby, being diagnosed with a life-threatening condition and undergoing major surgery. Please consider having further time off work if required.
For your information, 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. Also 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).
Generally, 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.
As a gentle reminder as you had the methotrexate injection, you should take a folic acid supplement for 12 weeks before you try to conceive. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the taking folic acid for 12 weeks before trying to conceive is so important.
Please be kind to yourself, allow time to grieve, to heal both physically and emotionally.
We will be here for you for as long as you need,
Sending much love and warm hugs,
Karen x
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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.