Trying immediately after an ectopic

Preparing For Your Next Pregnancy
1

Hi,

Having just read some info on here about waiting 3 months / two cycles to avoid risk of another ectopic, I am a little panicky.

Had surgery and left tube removed 13 days ago and was told as above to wait for 3 months. Then a few days later a nurse rang me with my blood results and said, unprompted that we could try again if we wanted as soon as I stopped bleeding. I said the Dr had told us 3 months and she said that wasn’t necessary and also that I’d be really fertile at the moment.

Because we have fertility problems anyway (besides being a tube down) we therefore decided to go for it as any opportunity to increase our chance seemed too good to miss. I think I’ve just ovulated and we have been trying for 6 days. Does anyone know if we are at more risk of another ectopic, should I fall pregnant? I am now so confused. I thought perhaps they just said 2 cycles for dating purposes / emotional healing after the nurse had said what she did.

TIA x

2

Hey,

I only know what the official advice is, but I felt super fertile the 2 cycles after I had my tube removed. I just finished my 3rd cycle where we began TTC and I don’t even think I ovulated… So I guess if she thinks it is a good idea, that is for a reason?

Good luck!

3

Dear Tia,

I am so sorry for your loss and so sorry that the nurse gave you bad and contradictory advice.

We and other medical professionals advise you wait for three months or two periods before trying to conceive to allow your cycle to return and there to be a clear Last Menstrual Period (LMP) date to date a new pregnancy from. Without this, they will not be able to scan you accurately and say whether they should or should not be able to see anything and are more at risk of missing another ectopic. Some studies do suggest that women who conceive immediately after treatment for ectopic pregnancy are more at risk of suffering a subsequent ectopic.

Waiting also allows the internal inflammation and bruising from the ectopic and any associated treatment to heal and for the necessary process of grief to surface and be worked through.

Hope this helps.

Much love,

Alex

x

4

Hey Alex,

thank you for your clear advice. I had my first period after my operation within a month and so was technically ready to conceive within two months of my operation (because I had by then had 2 periods). But I have to say my body still feels like it is recovering very much (it is now exactly 3 months since my operation). And while I am very keen to be pregnant again I am listening to my body and trying to take it slow and not get too disappointed if I am not pregnant again right away. I’m 35 and my age is making me anxious but I keep clinging to the fact that even though I lost a tube, I DID get pregnant once so I will again. Fingers crossed for everyone on here…

x

5

Thank you both for your replies and advice, I really appreciate it.

I am wondering if the nurse who rang didn’t see I’d had an ectopic and thought it was a natural miscarriage.

If the only issues are dating and emotional impact then I am happy to take my chances if it means our shot at a natural pregnancy (we’ve previously had to have ivf due to other major fertility factors). I would be on alert for any symptoms of ectopic of course.

I am however really worried about the studies you mentioned that say an ectopic is more likely if conceived immediately after the first, could you please point me in the direction of these please, Alex?

We stopped ttc after I read the info on here (the day I posted), but had been trying for 6 days and I think I had just ovulated or was just about to so there’s a chance I am pregnant - though fairly slim due to our circumstances.

I understand about the emotional healing side but I think everyone is different and though if pregnant soon it will be difficult in some ways, due to our fertility factors and really wanting a child I feel emotions wise, I would be much happier and less distressed pregnant than waiting.

Thanks again x

6

Hi Lamby,

I totally know what you mean about waiting versus the anxiety of just really, really wanting to be pregnant and be a Mum… My body still does not feel back to normal but the crappy way I feel sometimes is also because I just want to be a Mum! I’m so happy I did manage to get pregnant after trying for quite a while on and off. I am trying to focus on that and not focus so much on the loss. Positive thinking may not really work, but it makes you feel better on the way to whatever comes next! I definitely feel sad and bewildered about what happened but I really think becoming pregnant again would be the best thing ever…

Fingers crossed…!

7

Hi all,

I’m so glad to have found this website, so much useful information :slight_smile:

Tia, Hope you are doing ok. I also had surgery for my ectopic pregnancy and my left tube removed on Wednesday last week. I was so glad to find your post as I also have questions around trying to conceive again.

Following my surgery on Wednesday I was advised by the consultant who operated on me, that there was no need to wait before we try to conceive again (as long as we were ready). We are really keen to try to conceive again so I paid particular attention to this. The consultant’s advice was that there was no medical reason to wait.

Over the last few days I’ve been interested to find out more information about ectopic pregnancies and I have found a lot of conflicting advice, as you did Tia. Ranging from ‘wait for the first period’ / ‘wait 6 weeks’ / ‘wait two cycles’ / ‘wait 3 months’ and so on!! To contradict this I have found several NHS hospital factsheets that state it is perfectly safe to start trying again as soon as you are ready.

So I’m really interested to find some more information around this varying advice and specifically ‘are there any medical reasons to wait a period of time before trying again?’

I do fully understand that there is the emotional side to consider, and this will be different for every woman / every couple - so it would be impossible to put a timeframe around this.

I also appreciate that its is easier to date the pregnancy if you have waited a cycle or two and this is very important for identifying if there is another ectopic. Regular pregnancy testing and being on alert for symptoms would put my find at rest on this one.

I also appreciate that the situation is difference if you have had Methotoxate as there is a period of time associated with this remaining in your system. In my case I didn’t - it was purely surgical.

Given my consultants advice that there is no risk/issues, and conflicting info that I’ve found after this, I am also worried about the studies mentioned that an ectopic is more likely if conceived immediately after the first, I would also be interested if you can point me in the direction of these studies Alex?

Having just gone through this experience so recently, I am keen to make to most informed decision possible about trying again.

Thanks all, and best of luck to all who’ve been through this

Helen x

(I have also had a m/c (at 9 weeks) about 3 months ago, and another m/c (at 6 weeks) about 3 years ago. I’m very lucky to have a little boy who will be 2 in January.)

8

Hi all

Personally, I would go with the advice of the EPT as they work closely with medical professionals and are the absolute experts. So many doctors/nurses just don’t have specialist knowledge of ectopics and believe them to be the same as miscarriages where it’s generally fine to try pretty quickly. At the end of the day, it’s a personal choice, I guess.

But, I just wanted to address something you said, Helen, if you don’t mind – about regular pregnancy testing. I run several online ectopic support groups. We’ve had many women in the groups who have tried immediately and I’ve seen how confusing it is. They have to test every couple of days – not just for four or five weeks, but some have to test for up to 10 or 12 weeks as periods can take a long time to come back. And there has also been some confusion as some have tested positive but it’s been because their hCG levels hadn’t returned to zero after surgery. I’ve seen many times the panic, distress and confusion this has caused and it can be too much to deal with so soon after the trauma of an ectopic.

Re. waiting after mtx, it’s not because it stays in your body. The dose given is pretty small and leaves the body quite quickly. It’s because mtx can deplete folate levels and these need to be rebuilt before ttc again.

Good luck if you do start trying immediately. I just think, for the want of waiting another month or so, it’s better to give yourself every chance of a healthy pregnancy. xx

9

Hi there, thanks so much for your reply.

With regard to testing, that’s very useful insight, thank you. I understand confusion / mixed emotions that could be caused by frequent testing, this point is really important and in no way do I want to mitigate that.

However, as you’ve said this is a personal decision for me. And for me to make my decision I would like to know more about whether there is a medical risk associated with the stage that you start trying, as such I am interested in the studies mentioned that have been done in this area.

This seems such an important point and I want to make the most informed decision that I can. As you say, a healthy next pregnancy is so very important.

Thank you so much,

Helen x

10

Next time - I completely relate to all that you are saying. The emotional side is very tough and I feel both grief for losing our baby, and grief for what our lives could have been. Which is why, for me, I do want to start trying asap but I know everyone is so different. Good luck to you too - keeping everything crossed.

Helen - Thanks so much for responding to your post - you put so well everything that I’m feeling and why I posted this in the first place. It is the studies that I am really keen to see, so that I can base my decision on fact, not ‘maybe, probably, should wait…’ as TBH that really isn’t right for me. We have existing fertility problems which led to us undergoing IVF and now am one tube down as well, so if there is an increased chance of pregnancy soon after this loss, I really do want to take it, and feel emotionally ready. I have been unable to find any studies online, and was really pleased to hear of what your Consultant told you. I’m sure he knows his stuff and would not advise you it was okay if it wasn’t. I had been worried that the nurse perhaps had confused me with a miscarriage as she was just giving my HP level results over the phone, rather than when I was an inpatient sat in front of her.

I’m so sorry for all three of your losses, you really have been through the mill, and I so hope that you do not have to wait too long for your next healthy pregnancy x We also have a little boy, 17 months and feel so very lucky to have him. We would love to give him a sibling though, for us it has become as much about completing our family for him as it has for us.

If you do come across anything else, please let me know - I’ll keep checking in now (I hadn’t thought to check for a little while.) I am currently waiting to see if I am actually pregnant, eek, as before reading the conflicting advice we had begun trying, a week post surgery. I think it is fairly unlikely as I am feeling the typical twinges before the end of my cycle but we shall see. I’ll be very nervous about another ectopic of course, and look for signs, but would be so, so happy to be pregnant again.

Good luck and hope you are recovering okay x

PS - blue topaz, thanks so much for that info - really good point about the testing and the other stuff you raised as well :slight_smile: