Trying to conceive after an ectopic pregnancy
You must have heard of an ectopic pregnancy. It is a relatively common type of pregnancy which affects around 1 in 50 pregnancies. Ectopic pregnancy occurs when the fertilised egg is implanted outside the woman’s uterus, usually in the Fallopian tubes but it may also occur in the ovary, abdomen or cervix.
Not only does ectopic pregnancy end in the inevitable heartbreak of miscarriage, it can also be potentially dangerous for the mother as well.
The condition is described as ectopic because the fertilised egg fails to develop because it is in the wrong place and it often leads to abnormalities that prevent the pregnancy, though in rare instances term pregnancy can result.
In a normal pregnancy, the egg is fertilized in your Fallopian tube. It then travels through the tube and lands in the uterus, where it starts growing. But in an ectopic pregnancy, the egg doesn’t make it to your uterus. Usually, it gets stuck in your Fallopian tube, either because of a problem with your tube or the egg.
Sometimes, the fertilized egg implants in your ovary, cervix, or somewhere else in your abdomen.
At first you may not have any symptoms of an early ectopic pregnancy. They may seem very similar to a normal pregnancy. You might miss your period and have discomfort in your belly and tenderness in your breasts.
Only about half of women with an ectopic pregnancy will have all three of the main signs: a missed period vaginal bleeding, and belly pain.
Ectopic pregnancy can cause a Fallopian tube to rupture. If that happens, you could have major pain and severe bleeding, and you would need medical care right away. Possible signs include pain in your rectum or an intense urge to have a bowel movement.
Pain in your shoulder could also be an emergency. While it might not sound pregnancy-related, if one of your Fallopian tubes bursts, blood can pool near your diaphragm and irritate nerves that run to your shoulder.
If your pain is severe, sharp, and sudden, or if you feel lightheaded or dizzy, or if you’ve fainted, get medical help immediately. These are all signs you could be going into shock.
If you have had an ectopic pregnancy, you may be worried whether you can get pregnant again. This is an emotional time and you may be desperate to try to conceive again after an ectopic pregnancy and or may feel you need more time to emotionally and physically recover.
It is important that after a traumatic experience such as ectopic pregnancy you allow yourself time to recover. If you need to seek help at any point you should not be afraid or ashamed to do so.
The truth is that many women can continue to have children after the previous pregnancy was ectopic, but there are possible causes and/or effects that may cause infertility. Your chance of conceiving depends very much on the health of your Fallopian tubes. Statistically, the chances of having a future successful pregnancy are very good and at least 3 out of 5 women are healthily pregnant within 18 months of an ectopic pregnancy. This may rise to over around 85 percent over two years.
First let us discuss common causes of ectopic pregnancy. The reasons for an ectopic pregnancy are various. Believe it or not, any sexually active woman of childbearing age is at risk of an ectopic pregnancy and often the reason for the ectopic pregnancy will never be determined. However, ectopic pregnancies are more likely if you have had a previous ectopic pregnancy, fertility treatment, there is a chance of ectopic pregnancy resulting from embryo transfer during IVF treatment as embryos can travel into the Fallopian tube, for example, during the implantation stage. There is also an increased risk of ectopic pregnancy for older women, Pelvic Inflammatory Disease, PID, tubal surgery, endometriosis, etc.
The No.1 cause is blockage of a Fallopian tube as it prevents the egg from passing through and reaching the uterus. Half of cases of Fallopian tube obstruction are due to a pelvic inflammatory disease called salpingitis, which causes inflammation of the Fallopian tubes and may lead to infertility. However, the most common cause of pelvic inflammatory disease is chlamydia, a sexually transmitted infection that can cause inflammation without producing any symptoms.
The main risk factors for ectopic pregnancy include advanced age (above 40) endometriosis, adhesions caused by scarring from previous pelvic surgery and abortions. Sometimes the embryo is discarded directly by the body, even before producing any pregnancy symptoms. The woman may not even realise she was pregnant and, of course, not know that it was an ectopic pregnancy. In other cases, it can cause mild pain and bleeding, which is often interpreted as being associated with irregular menstruation.
If the embryo begins to develop outside the uterus, pelvic or abdominal pain may be severe and other symptoms such as nausea, discomfort and bleeding may occur.
In reality, 1 in 80 pregnancies will be ectopic. It is a devastating experience for a family; often an experience where all the focus gets put on the woman, but the man also has an overwhelming sense of duty that they have to be strong and hold things together for the rest of the family.
Recovering from the ordeal of ectopic pregnancy may be challenging but you can do it. Your body is likely to go through a whole process of recovery following an ectopic pregnancy and it is important that you be gentle with yourself and give yourself time to heal.
Because such an invasive and frightening thing has happened, it is not unusual to become very worried about any symptom you may experience and to have many questions racing through your mind. You may also find that you have different questions about your body at different stages after treatment.
Note that ectopic pregnancy is not hereditary. You are no more at risk of an ectopic pregnancy than anyone else, even if your immediate family members suffered. Also, miscarriage is not related to ectopic pregnancy.
Exercise and sport in general makes no contribution to ectopic pregnancy. Also, no evidence links ectopic pregnancy to flying, but you should not fly if you have or might be having an ectopic pregnancy.
In diagnosing an ectopic pregnancy, various tests are carried out. Ectopic pregnancies can be notoriously difficult to diagnose because it often presents with symptoms that can be suggestive of other conditions such as gastroenteritis, miscarriage or even appendicitis. As doctors we rely on women to give clear histories about their symptoms and so the more you can us about what has changed, what feels different and what is worrying you, the more likely we are to be able to diagnose you.
Can you get pregnant with no Fallopian tubes? If your fallopian tubes were removed or both have been deemed completely blocked, it is still possible to get pregnant with IVF because it bypasses the Fallopian tube and the embryos are placed directly into the uterus.
MD/CEO Nordica Fertility Centre