Residual tissue after ectopic. Is it safe to TTC?

Preparing For Your Next Pregnancy
1

Hello,

I was diagnosed with left ectopic pregnancy on March 2. After Laproscopic surgery, as bhcg levels were still rising, i received 2 doses of methotrexate. Bhcg levels then came down and went below observable amounts by April 21. Since then I have been taking folic acid supplements daily.

I went for a check up after 11 weeks of folic acid supplements and my blood folic acid levels as well as heamoglobin levels are now normal. But, during ultrasound diagnosis, the doctor discovered that there is still a mass on the ectopic side (left). The doctor says they think it might be the residual tissue from the pregnancy. They are not sure if this mass is blocking the tube or not. they told me that i can start TTC, but the clear presence of the mass on ectopic side is a big worry for me.

I am impatient to have a baby and donot want to wait anymore. but does this residual mass mean any harm for the next pregnancy? if yes, how long should i wait? the doctors i see offered no timeline as to when, or if the mass will get reabsorbed.

should i go for further investigations or treatment for the residual mass before TTC again? I would be grateful for any advice on the matter.

Thanking you

Regards

2

Dear lily456,

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

In the UK, women aren’t routinely scanned or offered additional investigations to see if a mass is still present before ttc again, so most wouldn’t know if there was a mass still present.

The ‘reabsorption’ you refer to can take weeks and sometimes months to be complete. I am afraid it can be difficult to be precise because our bodies are all unique and we respond differently physiologically with what is happening. In some instances, the fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink and, occasionally, it may not shrink and will leave a blockage in the tube by way of a small cyst. However, the use of Methotrexate does not reduce the chances of successful future pregnancy, whatever the outcome in the affected fallopian tube.

It is generally possible to conceive after an ectopic pregnancy. The time it takes to conceive successfully after an ectopic pregnancy varies considerably from couple to couple. This can be affected by factors including age, general health, reproductive health and how often you have intercourse (sex). Overall, 65% of women are healthily pregnant within 18 months of an ectopic pregnancy. Some studies suggest this figure rises to around 85% over two years.

Sadly, it is not possible to stop an ectopic pregnancy from happening. Importantly, help is available with future pregnancies with an early scan at around six weeks gestation to check that the embryo is in the right place. We are here too for emotional support, as and when you need us.

We have more information on testing on our website here-

https://ectopic.org.uk/patients/trying-to-conceive/

If this is something you wish to pursue, I advise speaking to your GP or fertility specialist if you are not in the UK.

I had methotrexate injection for my ectopic pregnancy, I like many women did not have any follow up scans and I went on to have a successful pregnancy. I hope this helps a little.

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

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Further information is available at ectopic.org.uk

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3

Dear Karen,

thank you for the reply. It means a lot to me that you have taken time to address my specific issue.

Thank you for the sympathetic ear and words of comfort.

Hoping things tun out for the best.

Regards

4

I’m glad you’ve asked this. This question of when and how the tissue will or will not be reabsorbed is really worrying me too. There’s virtually no information I can find about it. The idea that it’s still there is really concerning me with trying to conceive again. But the professionals don’t seem worried about it.

Wishing you best of luck.