Why do we wait 2 cycles?

Cortana · 9 June 2020 16:35

I had surgery at the end if April, since then I’ve had a normal cycle and period. I am due to ovulate this week and feel emotionally ready to try again. Some sources say wait 1 cycle, others say two. I feel healed, emotionally ready and have a clear first day of last period from my last period in may.

What else am I waiting another cycle for? Do I need longer to recover from surgery internally?

Some sources say research shows a higher rate of miscarriage if you try straight away, do you know what this research is and how likely this risk is?

Thanks millions for any advice.

K x

EPT_Host_20 · 10 June 2020 08:55

Dear Cortana,

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

We and many medical professionals advise waiting for two menstrual cycles. It is important to allow time for your body to recover and emotions to surface and be worked through. This is so that you have some comfort that your body is returning to its natural rhythm and you have a last menstrual period date from which to date a new pregnancy - key information in checking you are not suffering from an ectopic pregnancy in the future. The first bleed soon after surgery for ectopic pregnancy is not classed as a period as it is the body’s response to falling hormone levels.

Sending much love,

Karen x

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Cortana · 10 June 2020 11:20

Thanks Karen. I am not sure that really answers my question though. I have a last period date from my period two weeks ago, I am not using the first one that I had when I had surgery. And having had a miscarriage before I feel ok emotionally.

I am interested to know about the research suggesting you are more likely to miscarry again if you try immediately and also to know if my body is likely to still need time to recover inside from surgery as I feel like I am healed it obviously can’t see inside stitches.

Thanks

EPT_Host_20 · 14 June 2020 18:27

Dear Cortana,

I’m sorry I didn’t answer your question fully, the problem is that sadly there is very little research completed regarding early baby loss so there is little evidence we can pass on to you.

I passed your question onto our senior advisors who also advised about the lack of evidence but replied stating that we often hear from women who receive varied information about timings to try to conceive again. From a practical point of view, as periods can be different after having an ectopic pregnancy, having two proper bleeds provides women more of a picture of what their menstrual cycle length is with the two dates.

The first proper period you have after an ectopic pregnancy is also likely to be heavier than usual and the second more like your usual period. A normal period would suggest you are hormonally ready to be able to try to conceive.

A study was identified but it looks at intervals of 0-3m and >3m in the main and doesn’t go into more specific detail from what I can see.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780347/

It is impossible to know at exactly which point you will be fully physically healed and it can take up to six weeks. As there is no clear, researched evidence on how long a woman should wait to try to conceive after an ectopic pregnancy, the information on our website sets out practical and emotional reasons why many medical professionals advise waiting at least two proper periods including last menstrual period date, physical healing, hormonal healing, and emotional healing.

Another issue to be aware of with TTC at this moment in time is the services offered by general hospitals due to the Coronavirus.

Normally we and many doctors recommend booking an early scan when you are next pregnant and this is to check that the embryo is in the right place. This scan takes place at around six weeks gestation. However, in the current climate with coronavirus, the UK’s National Health System is seeing a reduction in resources and capacity and there is the aim to minimise hospital attendance. In light of this, guidance by the UK’s Royal College of Obstetricians and Gynaecologists states:

“Unfortunately, early pregnancy units will not be able to offer ultrasound scans to provide reassurance to women who have no symptoms. This will also be the case even if you have a previous history of miscarriage or ectopic pregnancy.”

This means that if a woman is pregnant again after an ectopic pregnancy, she may not be able to have an early scan in the current pandemic. I would suggest contacting your local early pregnancy unit to find out whether they are conducting early reassurance scans at six weeks’ gestation for women who have previously experienced ectopic pregnancy.

This is from a UK healthcare perspective, and even if you are located in another place, there may be similar considerations and processes in place to manage hospital attendances during the coronavirus pandemic. Ultimately, it is your and your partner’s decision and I hope that this information can help in your discussions.