Second ectopic--expectant management but need advice

hi everyone

This is my second ectopic. I had one 8 years ago BUT I also have a lovely six year old boy (so there is hope all my wonderful ladies out there who are worrying about their fertility). I reckon I’ve had a PID because the doctor this time around said he could see a lot of scarring on my left side. This second ectopic is in the same tube as the first. My body is sorting it out and I’m in expectant management with my levels going down to 46 yesterday. Living in fear of death these last four weeks has been…bloody terrifying. I’ve not really had time to grieve really. We didn’t think I could get pregnant because of my age (42) so it’s been a shock all round. The doctor last friday was concerned about my levels not going down and told me we’d be better operating and taking the tube out because it was just going to happen again. Then he changed his tune and said let’s wait and see and now that my levels have gone down from 60 to 46 he said yesterday we didn’t need surgery. I’m confused. he was all ‘surgery will help your fertility’, ‘the likelihood is you’ll have another ectopic’, "your ovary is stuck to your bladder and so we can sort that out’ but now it’s no surgery. Time is defo not on my side. They say I can have the surgery and get my tube removed if I want. I don’t know what to do. The nurse said if my tube is removed then I’ll need IVF (which for various reasons is a no-go for me) but the consultant said it wouldn’t affect my fertility that much and the left tube is finished anyway because I’ve had two ectopics. But then (I think because of resources) he shifted back to the wait and see approach. Expectant management is working for THIS ectopic pregnancy but is it the best thing for my future fertility considering I have not much time and higher risk of another? I suspect that this is more a resource issue than what’s best for my future ferility with the poor NHS being the way it is—willfuly starved of funding. But I’m not sure. So any advice is welcome. Keep the tube or have the tubal surgery. I can have it later through the clinic the nurse said if I want. They can go in and have a look and see what’s going on. There’s a lot of scarring in there. I have cysts too and the ovary is stuck to my bladder. He wondered if i had endo but I’ve got no endo symptoms. My periods are light though I’ve been spotting through the month before I got pregnant. ANY advice welcome. Thanks lovelies xx

I found this

https://obgyn.onlinelibrary.wiley.com/d … 2/uog.5186

Makes me feel better!

Dear kezarye2,

I am so sorry to hear of your ectopic pregnancy and loss. To experience one loss is difficult to deal with multiple losses is heartbreaking and my heart truly goes out to you.

Sadly I am not medically trained and without access to medical records, it is difficult to advise you on your best course of action. I would advise talking through your options with your fertility specialist, who may suggest further investigations prior to you making a final decision.

It is however, good news that your hCG levels are falling.

Sending much love,

Karen x


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