TTC after ectopic

[TheUNITUBER]

HiI thought it might be good to have a thread for women ttc after an ectopic pregnancy, or those in their "waiting period" to begin ttc again after treatment. Trying to conceive after ectopic has its own particular difficulties, IME, because of the fear of it happening again. If there is anyone out there who has experienced this and wants to talk, I'm here.My story: I had my first ectopic earlier this year and was treated with methotrexate. I waited three months and conceived again in July, which became a chamical pregnancy. With both of those pregnancies I just knew that something was wrong - although I did not have a single "classic ectopic" symptom. Then in August I was thrilled to become pregnant again and this time the pregnancy seemed completely normal. Unfortunately it was another ectopic in the same tube as my first and this time I lost the tube. I'm recovering from the surgery and feeling rather shell shocked at the moment. The first time I had an ectopic I thought it was just bad luck, and lightening would not strike twice in the same place. Then it did, and it is huge thing to process. I very much want another child (I already have one) and feel like time is getting away from me.So, if anyone is going through this too and would like to talk, please pipe up. Or if you have been through this and come out the other side (preferably with a successful pregnancy to show for it) please could you post? I could use some hope right now. Thanks

Hi Bandanna

I'm sorry to hear that your ectopic was such a difficult experience for you and your DH. It is awfully shocking, I know.

Neither of my ectopics ruptured but I had methotrexate the first time and surgery the second. They were treated at different hospitals which just had different policies about the treatments they would use.

Even with an unruptured ectopic, many hospitals won't use methotrexate if your HCG is too high, the embryo has a heartbeat or if it is over a certain size. The hospital where I had my op simply does not use it because the consultant who runs the department apparently "thinks it doesn't work". (I've no idea why).

I just think that a lot of gynae work is about making an educated guess and choosing what the doctor in question thinks is the best option. So I agreed after my second diagnosis that they should remove my tube. I had assumed therefore that it would be a quick procedure. In fact in theatre the surgeon thought he could save my tube and tried (but failed) to do so for some time.

FWIW, I've read that having a tube removed does reduce chances of having a future ectopic because hopefully it leaves you with one good tube rather than one good one and a scarred one. It also effectively eliminates the risk of some of the pregnancy being left behind and needing more treatment which sometimes (rarely) happens if the tube is saved.

Hope that lot helps, and I wish you lots of luck in trying to conceive.

Thanks, that does help. From what you say maybe my HCG was too high. She said you should be able to see evidence of a pregnancy on scan with a HCG of 1500 and mine was 5500 the night before theatre. And I'm sure you're right, each consultant will have a different opinion of what management is the best.
Thanks for your reply.

That does sound high Bandanna. Many hospitals use either 3000 or 5000 as the cut-off for using methotrexate. Studies show that the higher the HCG level the lower the chance of methotrexate working (and of course if it doesn't work, you end up in surgery anyway but it is a big emergency instead of the nice controlled procedure that you and I had).

Hi all - i'm a newby to this so hope you don't mind me joining! I had an ep 6 weeks ago and lost my right tube - my husband was away with work so i was all by myself which was very scary. i'm desperate to start trying again, but also really scared. took me 2 years to concieve first time which ended in miscarriage at 12 wks - then had a little boy 8 months later..then ep... i'm most scared about getting back into the whole ttc cycle again...but with even less chance. read on one site that if you had trouble concieving you only have 10% chance. does anyone know if this is true anyway, just hoping to find some support as i'm still having lots of bad days x

Hi Alwayshope.
That does sound like a very traumatic experience. My DH was away when my first ectopic was diagnosed and treated so I know it's not much fun dealing with it alone.

I can't find any stats right now about conception rates in women who have fertility issues before an ectopic, but I know that after a salpingectomy fertility rates are only supposed to reduce slightly because the remaining tube can pick up an egg released by either ovary. Do you know what caused your delay in conceiving in the first place? Have your subsequent pregnancies been easier to conceive? If so, maybe there is no issue and your ectopic was just one of those crappy things? (About 50% of ectopics have no discernable cause BTW).

What I know for sure is that fertility is not an exact science. That's why if you ask 2 doctors the same question they'll give different answers. The problem with looking at statistics or what happened to other people is that they don't really tell you what will happen to you. Your remaining tube might be absolutely fine, you never know.

I know it can be scary trying again, but the way I look at it is that I want another child and for me it would be worse to not try and not have one than to try and maybe have another ectopic. I know they are frightening, but after your first ectopic the doctors are much much better at checking you over early so treatment can be less of a panic.

I'm going to try to find some details on fertility rates for you. You might also try speaking to The Ectopic Pregnancy Trust who seem to be the font of all knowledge.

Take care

Alwayshope - I've had a dig around and I can't find anything that suggests that if an ectopic happens to a subfertile woman her chances of conceiving are reduced to 10% - the figures that I have seen are far better than that. Obviously if your remaining tube isn't great having one removed is not going to help. Did your Dr have a look at the other tube during the surgery?

Hi everone hope your all well!! Just thought i'd say hello haven't been on here for a few weeks! My AF finally came today thank god! It was dead on 5 weeks since my bleed after my ectopic, so im now counting the days until I can start using my ovulation tests again and get busy! I do feel ready again now, I know its only been around 6 weeks but I so want to be pregnant again,I keep thinking i'd be 3 months today, never mind! 'It wssn't ment to be' I keep being told, Fingers crossed!!x

Hi all, I had an ectopic in may that reuslted in emergency surgery and tube removal....I have just found out I am pg again!! I am really happy that I can obviously conceive, but worried as I have had 6 mcs before the ectopic (but also have 3 dds).

Best ofluck everyone - hopefully I am proff to you all that even aged 38 and with one tube you can still get pg again!!

Hello, please can i join your thread?

I had an ectopic 3 years ago. I am very fortunate that I had 2 DC already. Never had any problems so this was a bit of a shock.

My ectopic ruptured and I ended up in emergency surgery to remove my left tube. Spent a few years after that trying hard not to get pregnant as I was terrified of ending up that poorly again. I still am really but my desire to have another baby is so strong that DP and I are TTC again.

AF due any day so its that time of the month where i'm keeping everything crossed and reading too much into every little ache and pain.

can you ladies help this mner please

Hi Memoo
Poor you having such a traumatic experience with your ectopic. You must be brave to try again after all of that.
It might help you to know that out of my 2 ectopics, neither has been particularly scary or painful. Once you have had one the hospital keep such a close eye that when you get pregnant again if it is ectopic they will spot it early and it will be dealt with in a controlled and calm manner. With my second, I had a laparoscopy and was back at work and pain free in less than a week so it is not always awful. And also you should know that the odds are overwhelmingly on your side - there's an 85-90% chance that when you do get pregnant it will be in your uterus.

Good luck for this month. Don't worry too much about the aches - I am sure a few twinges are part of a normal pregnancy too.

Well AF arrived so I'm not pregnant.

Why does it feels like such a blow. Every time I feel like I am pregnant and then I'm not I feel this real sense of loss.

I was so sure this time, had so many symptoms. I think I'm maybe losing my marbles and imagining it all. I'll be having a full blown phantom pregnancy next

Hi there,

Would you mind if I joined your thread? I am sorry to hear about your experiences because I have been down the road twice. Ectopics combined with infertility are hugely painful.Have you spoken to the ectopic pregnancy trust? I have found them hugely helpful and supportive.
Anyway I had two ectopics (one in each tube) over the course of four years. My first tube was removed (which shouldn't have happened because my BHCG levels were in the region for treatment with meta. I was seen in Ireland and there is an issue with metatrexate and abortion in some hospitals). Since both my tubes are now damaged (one removed and one treated with meta) my only option was IVF (hard for us because we've little money). Happily I got pregnant on my first cycle and I have a DD 5 months old. I have started to think we might try again naturally but am worried about a subsequent ectopic in the remaining damaged tube so I guess once we start I am going to have to buy in pregnancy tests and go for a scan immediately i get a positive. We are also thinking about a frozen embryo cycle in the summer of next year because I would love a sister or brother for my DD.

Love to talk more, good luck all...

NS XXX

Hi Newbishad, welcome to the thread . How lovely that you've managed to have a baby after all of that. It's really nice to hear.

Re the methotrexate, some hospitals in England don't use it either - most notably UCLH where I had my second ep treated a couple of months ago. My HCG was only 1200 or so that time and they operated and I lost the tube. Having said that, possibly my second ectopic was caused by damage from the first (as MTX sometimes leaves scarring and cysts behind) so I feel much better having got rid of my gammy tube.

Memoo I'm sorry your period arrived. Mine did too (we shouldn't really have been trying again yet but I wasn't entirely careful), but was 2 days late so that was annoying...

Dropdeadfred have you had a scan yet?

This weekend has been very hard. A good friend has told me she is pregnant - she must be due around when my latest ectopic would have been - and my response was to cry (I just couldn't hold it in). I apologised profusely, but ever since then I have felt knackered and totally defeated. I thought I had bounced back quickly after my latest ectopic but I feel like I have been hit - literally, I had a physical reaction to her news. I feel like a total bitch and am genuinely pleased for anyone who manages to conceive easily and who has a straightforward pregnancy, but I just can't help feeling bad at the same time.

Anyway, this week DH and I are off to see the fertility specialists privately to see if they have any advice which is more proactive than to just keep trying (the NHS's suggestion). I'm really quite upset that we've reached this stage, but needs must. At the very least I hope to get some reassurance from our consultation.

Mrs. Happy,

Hi there...Thanks. I just want to say I know exactly how you feel about your pregnant friend. During our 4 years ttc it felt as though the whole world was pregnant except me. Three secretaries at work, a colleague who sat opposite me and my brother's ex partner (who was in a totally unsuitable situation) all seeemd to be able to have children the first minute they tried. It was so hard trying to remain positive on the outside. Yes I too burst into tears when my friend who worked opposite me went on about babygrows. Try not to worry about crying at all...it doesn't hurt for others to see just how painful the whole thing is...unless you are faced with infertility you can't know the pain and anguish and I am sure your friend was very sympathetic as was mine.

I am glad you are moving on and seeing the fertility specilaists. It is a long hard journey and totally unfair, having to go through all that treatment and money for something that should be so natural. However, it is an important step. I have been told that as a group woemn who have damaged tubes tend to do well at IVF because the block is bypassed. Of course you can't know how or what will be suggested but I have met a lot of women who have been through our situation and done well at infertility treatment. In fact the first successful IVF cycle (Louise Brown) was born to a women with blocked tubes.

I hate it when the NHS say keep trying. I was told this by hundreds of doctors (both private and in the state hospitals). If I had listened to them I would still be trying now. Whilst lots of women can have an ectopic and go on and conceive naturally many others (like me have minute damage to both tubes and need fertility treatment.

Good luck and let me know how it goes.

Lots of love,

NS XXX

Thanks NS. We are lucky enough to already have a child (conceived naturally after 6 months of trying), but something seemed to go wrong after that. I had an emergency c-section and I can't help wondering whether that is the culprit in all of this. Both of my ectopics were in the same tube (I think - my GP has no record) and so I hope that my left tube is fine, but we have no way of knowing unless someone pulls their finger out and does an HSG. I am extra worried because with both of my eps I thought (as did the hospital) that I had ovulated on the left side and for some reason that tube did not pick the egg up - so I worry that it does not work. I hope, since I seem to conceive relatively easily, even if they do land in the wrong place, that I will do ok at IVF if it comes to that. I just cannot bear the thought of trying for another year or two without someone taking charge of my care and trying to help us.

Good luck to you too. If you don't already can I recommend that you chart your temps? I know it sounds like a hassle, but with my first ectopic the HPTs came up negative and then I had what I thought was my period. It was only because my temps were higher than they should have been for a non-pregnant woman that a couple of weeks later I did a test (BFP) and took myself off for a scan because it did not seem right. Anything that helps you to catch any further problems early on is so worth the effort in my view.

Hopefully we'll both get pregnant in short order and all of this will be in the past.

Hi everyone! Hope you are all well! Havn't been on here for a few weeks, been busy. I'm really hoping to be preg this month,though a little worried as Ive been experiencing pains on my left side where my ectopic was, I have been busy BD and using ovulation tests this week, hoping I'm as successful as in July but with a happy ending this time! Though I don't know if I would experience pains in early fertilization stages or what ever stage it is within a week etc??

Mrs happy could you please give me some info on temps please, this may be helpful to me!

I hope everyting goes ok for everyone!xx

Hi Ellsbellzie

Try not to worry too mch about the twinges (easier said than done, I know). I reckon that hormones can cause all sorts of business to go on, some of which you can feel. And after an ectopic you are bound to be super sensitive to it all.

Re the temps, you get a basal body thermometer (from, for example, babymad.com or access diagnostics) which show 2 decimal places. You then take your temperature every morning at the same time before you get out of bed, speak or do anything. The idea is that progesterone causes your temp to rise so you have lower temps before ov and higher temps afterwards. When you get pg your temp stays high, but if you are not pg your temperature falls and your period begins. If yo get 18 high temps in a row you are probably pg (but there are a couple of other unusual things that can do this too). There's loads of useful info on Fertilityfriends.com if you are interested. With any luck you won't need it though!

Theunituber: Wow! Hearing your story is like reliving my own! I too had an ectopic pregnancy in february of this year...At 9 weeks I was treated with methotrexate and fortunately it did work...I waited out six months just to be on the safe side because it took almost 4 months for my HCG levels to return to normal! The very first month we started trying again I got pregnant...This pregnancy also seemed normal. My levels were rising as they should and eveything seemed fine...At 6 weeks I was rushed into emergency surgery and had to have my left tube removed as it had ruptured and I was bleeding internally. Anyway, it has been 5 weeks since the last ectopic and I am desperate to try again! I have a little boy who is 5 years old and I know how badly he wants a little brother or sister...How long were you advised to wait before trying to concieve again? I need some positive stories from anyone please! I really hope there is still hope for me!

Hi ChristaMc

I am theunituber but have changed my name.

How strange that we have such similar stories. I'm just sorry someone else has been through it too, but it's good that you're well enough to want to try again after such a scary experience. As for how long to wait I have been told lots of different things. The guy that did my surgery said "3-6 months but it won't hurt if you get pregnant sooner" (helpful). The ectopic pregnancy trust said two complete cycles, as does my GP. Women who have the same operation but for hydrosalpinx (where the tube is filled with fluid) instead of for ectopic are told they can try right away. Me and my DH decided that we couldn?t wait and gave it ago when I was ovulating 4 weeks after the surgery. I didn't get pg but then I ovulated on my tubeless side.

The reasons for waiting are to allow physical and emotional healing. The emotional bit really depends on how you and your DH are feeling. For me the thought of having another ectopic is nowhere near as bad as the thought of not having another child for ages. As for physical healing, well different women heal at different rates and I just think that if my body is not well enough to get pregnant then it won't. I don't know if I am being a bit to fatalistic there, but that's how I feel. The EPT also says that some studies suggest a higher rate of repeat ectopic if you try again too soon. I have looked all over the net and haven't found any study saying that (which is quite possibly because I am not a subscriber to lots of medical journals!) but again I just think that if I am going to have another ectopic I would rather it be sooner than later. Not sure if that is terribly logical, but it is how I feel.

Starting to ttc again does have its stresses, though. This week's worry is that my remaining tube doesn't work (this is fuelled by the fact that with my last ectopic the egg was from one side but the pregnancy was on the other). Perhaps if you are still very upset about the ectopic these sorts of things would be hard to deal with. And since I would now be about 13 weeks people whose babies are due when mine would have been keep telling me they are pregnant. That's pretty hard to take.

I'm starting to do something practical about this all and am now under the care of a fertility specialist (had to go private for this) and so the task of the next few months is to figure out if my one tube works and if not, maybe to go for IVF. It's a bit full on - just 3 months ago I would have told you I would never need IVF and here I am saving up for it. At least things are getting moving though.

Anyway, I hope you're recovered from your surgery and that you get pregnant with the bean in the right place soon.

It really does help to hear other peoples stories...makes you realize that you really arent alone! (Although I feel that I am most of time). It will be 6 weeks since my surgery this Friday & I was told by the surgeon who did my surgery that I should wait 2 cycles. I have already had one last week but I really feel ready to try again! I am afraid though that if I try too soon it will be ectopic for the third time & I just dont know if I could handle that again...I was told however that my other tube looks healthy & both times that I did try before I got pregnant on the first month..so getting pregnant isnt the problem. I just keep telling myself that the "bad" tube is gone so it wont happen again...Thats really not the reality of it though is it? How long have you been trying since your surgery? Isnt it possible to get pregnant even if you ovulate from the tubeless side?
Anyway..thanks so much for writing back! I hope things work out in your favor soon!

Also, I too had an emergency c-section with my son...do you really think this could be what caused the ectopics?

Christa, I had my surgery almost 2 months ago now so really I feel completely healed, although obviously I still have some pretty hideous scars.

I also tend to think that once the bad tube is gone hopefully that's the end of it. I guess it's not always the case (e.g. if you had damage in both tubes from an infection) but for a lot of women that is the end of it. I think that even though I have had 2 ectopics I am actually in the position of someone who had one and had a salpingectomy right away.

Yes, it is possible to get pg if you ovulate from the tubeless side. In fact the other week I read a study that suggested that this happens in 30% of all pregnancies, ectopic or not. The study suggested that when an egg is released it sits in the Pouch of Douglas. The fallopian tubes "sweep" through the space and hopefully one of them picks up the egg. Pretty amazing stuff.

Re the c-section, abdominal surgery is a risk factor for ectopic pregnancies (not that they tell you that at the time!). The specialist I saw told me that he thinks that is what caused my problems, as everything was fine a few years ago and the csection is a known cause of fertility problems. The thing is that I read that 50% of ectopics have no known cause so I would guess it is at least as likely that your ectopic was just bad luck (and that the first caused the second IYSWIM). I guess we'll never know exactly what is to blame, but I am thinking that if I just happened to have some adhesions from the operation on my bad side hopefully that leaves me a perfectly healthy tube that can get the job done!!

I sympathise with your feelings re trying again. If you are not sure whether you could deal with another ectopic, maybe you should wait. It sounds like for you it will only be a few weeks more, so not too long to hold off.

Thanks so much...you are very knowledgeable on this subject! I am guessing you have probaley spent as many hours as I have researching and trying to find anything that makes this all sound better! Anyway...I am going to wait antoher cylce...just to be safe...hopefully soon enough we will be telling each other that our stories are alike in another way..and that we both managed to get pregnant right away! Thanks for the talk..it really has helped!

I spend far too much time reading up on this subject! Just looking for answers I guess, but there hardly ever seem to be any.

Lots of luck to you. Wouldn't it be great if we both got pg soon? Am sure there's light at the end of the tunnel; it just might take a little bit of time to get there.