Will I have tube damage?

Preparing For Your Next Pregnancy
1

Hi all, I recently had a small 1cm ectopic mass in the Left tube which was treated with 2 doses of MTX. We can start trying again in July and whilst I’m happy to have saved my tube I’m also a bit confused about trying again…

Is the ectopic likely to have damaged my tube? I’ve been doing online research but can’t really find anything about this.

I’m considering having a hycosy procedure in the hope it would give me peace of mind, but equally, if they do find a blockage I’m also not sure what I’d do with that information- would my only option then be surgery?

Part of me thinks just try again and hope for the best but i don’t know if that’s sensible and I’d be devastated if it happened again.

Does anyone know how likely it is that there is tube damage and what are thoughts on having the hycosy?

Thanks

2

Dear NParchie,

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

It’s a question that many of us are faced with following ectopic pregnancy. Why this happened and will it happen again. Sadly for many of us, including myself, there is no reason why we experience ectopic pregnancy. Sadly I cannot answer your question on how likely there is to be damage As we just don’t know. In the UK, women aren’t routinely offered testing following ectopic pregnancy and the advice to wait for at least two menstrual cycles before trying to conceive allows the internal inflammation and bruising from the ectopic and any associated treatment to heal. (The first bleed straight after ectopic pregnancy is caused by falling Hcg levels and is not classed as a period). If you have questions specifically about testing, I would discuss these with your Dr.

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.

Importantly early scans avail. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.

as a gentle reminder, If you have had either one or two injections of Methotrexate you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood tests) and then take a folic acid supplement for 12 weeks before you try to conceive.

Making the decision to begin trying to conceive is an emotional rollercoaster compounded by our sad loss. Again, you are not alone. We here emotional support whenever you need us.

Sending much love,

Karen x

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Hi there

It’s really hard to know if you have tube damage or not - I have the same thoughts and did a lot of research online and while most of the info I found was reassuring (most tubes aren’t blocked, most aren’t thought to be damaged in the tiny tiny numbers that were physically inspected, most women receiving treatment conceive again non-ectopically etc.) I knew that it’s different for everyone and research wouldn’t tell me about my own situation. It depends on your pre-existing factors that led to the ectopic, as well as your hCG when you received mtx, how easily it resolved etc.

I ended up not getting a HyCoSy as it sounded painful and my doctor didn’t seem keen, and it shows blockages but not if the tubes (cilia etc.) are working. However, I know sometimes it can clear smaller blockages, and I think if I were more brave I would have gotten it done just for a little extra peace of mind. So, yes if there’s a large blockage then surgery might be required, but alternatively you could just choose to time pregnancy attempts with when you ovulate on the other side, or the HyCoSy might clean it out, or you could choose IVF, etc.

In my case I was able to get pregnant again without IVF, it is in my uterus, and I did ovulate on my ectopic side (although can’t guarantee it went down that tube). I was so relieved!! I waited several months after the 3 month mtx wait.