If You Had Ectopic Pregnancy Can It Happen Again
Trying to Conceive Once more
Explaining Ectopic Pregnancy: Trying to conceive again (with subtitles)
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If you or someone you know needs support with an ectopic pregnancy, delight feel free to contact united states of america.
Answering your questions on conceiving later on an ectopic pregnancy
It is likely you accept been brash to look for three months if you have had methotrexate, or for two full menstrual cycles (periods) later surgery, before trying to conceive. The bleed that occurs in the first calendar week or so of treatment for an ectopic pregnancy is not your kickoff period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy.
Statistically, the chances of having a futurity successful pregnancy are very skilful and 65% of women are healthily pregnant within eighteen months of an ectopic pregnancy. Some studies propose this figure rises to around 85% over two years. The time information technology takes to excogitate and chances of conceiving depends on many factors such as the health of your Fallopian tube(s), historic period, your full general and reproductive health and how often yous have sex.
Detailed general information can be plant here on our website. Please retrieve that online medical information is no substitute for adept medical care from your own healthcare team.
Below is a list of common questions that we are asked about trying to conceive. This page covers questions on timing, ovulation, lifestyle, testing, assisted conception, and pregnancy tests.
Time related questions
Why must I wait for 3 months before trying to conceive?
While there is no articulate, researched show on how long a couple should wait to try to conceive afterwards having treatment for ectopic pregnancy, we and other medical professionals advise that information technology may be best to wait for at to the lowest degree three months or two total menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The bleed that occurs in the first week or then of handling for an ectopic pregnancy is not your first flow. It is the drain that occurs in response to falling hormones associated with the lost pregnancy.
Physically, this timeframe is to allow your cycle to return to normal and for at that place to be a clear menstruum to date a new pregnancy from. The date of the first day of the period is what is used to determine when to browse a new pregnancy; data that is invaluable in ensuring you are not suffering from another ectopic pregnancy.
The commencement proper period you lot have after an ectopic pregnancy may be heavier than usual and the second more similar your usual period. A normal period would suggest you are hormonally ready to be able to effort to conceive. Having ii periods tin can also give an idea of menstrual bike length, which may exist different for a few months after your ectopic before settling back into its usual rhythm.
This wait allows the internal inflammation and bruising from the ectopic and whatever associated handling to heal.
In addition to the physical aspects of ectopic pregnancy, many people also experience an intense emotional impact. Taking time before trying to conceive again enables the necessary process of grief to surface and exist worked through. The emotional recovery that is oft needed can be significant and many underestimate this aspect.
If you have had either one or two injections of methotrexate, y'all should wait until your hCG levels accept fallen to below 5mIU/mL (your physician will advise you when this is through blood or urinary tests) then take a folic acid supplement for 12 weeks before you endeavour to conceive.
This is considering the drug may take reduced the level of folate in your body which is needed to ensure a baby develops healthily. The methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs, and the quality of your blood for upwardly to three months after information technology has been given. The medicine tin likewise bear on the way your liver works and and so y'all need to give your torso time to recover properly before a new pregnancy is considered. A shortage of folate could outcome in a greater adventure of a baby having a neural tube defect such equally scissure lip and palate, or even spina bifida or other neural tube defects.
If you have had medical management followed by surgery, you can kickoff taking a folic acrid supplement again once your doctors take confirmed that all of the pregnancy has resolved. This is especially important if you have been having claret tests to cheque hCG levels later your surgery. Yous can start to attempt to conceive over again 12 weeks after the engagement that the methotrexate was administered.
The NHS website has more information on vitamins, supplements, and diet during pregnancy.
Ovaluation related questions
When will I ovulate again?
Earlier your first menses arrives, you will ovulate. The period when it returns will indicate that you are ovulating once again. It is possible to ovulate 14 days after surgical treatment and during methotrexate treatment, so it is important to be aware that information technology is possible to become significant without having a period showtime, if you lot are not using some form of contraception.
Accept I only got half of my fertility?
When a person has but ane Fallopian tube, they are however able to get significant from an egg released by the contrary ovary as an egg from ane ovary can travel down the Fallopian tube on the other side. Approximately 1-third of pregnancies are a result of pick-upward of the egg from the ovary on the opposite side to the remaining Fallopian tube. Information technology may exist reassuring to know that when you ovulate from the ovary by the removed Fallopian tube which is opposite to the remaining Fallopian tube, it is not a 'wasted' bike.
What do ovulation kits predict?
An ovulation predictor kit measures Luteinising Hormone (LH). A surge in LH leads to ovulation within the next 12 hours. The egg does not always get released from the ovary in spite of a surge but information technology is a very good mark. A positive pregnancy test effectually xiv days later on you call up ovulation occurred is the but way of establishing that information technology actually did.
Urinary ovulation predictor kits are used typically daily around the time ovulation may exist expected. A conversion from a negative to a positive reading would suggest that ovulation is nigh to occur within 24–48 hours, giving ii days to engage in sexual intercourse or artificial insemination with the intention of conceiving.
As sperm can stay viable in the female reproductive system for several days, LH tests are not recommended for contraception, as the LH surge typically occurs after the beginning of the fertile window.
Is it true that I ovulate on alternate sides each month?
We naturally assume that we volition ovulate from alternative ovaries each month (left ovary, right ovary, left, correct etc.) This is non truthful and varies. Some will ovulate from the same side each month with an occasional ovulation from the other side, while others will ovulate randomly from side to side.
Both ovaries compete each month to produce an egg and usually, the one that is 'pulling ahead in the race' continues while the other one gives upwardly (merely not always – sometimes ovulation occurs from both ovaries in one cycle or twice from 1 ovary – this explains how we go non-identical twins naturally). It depends on which ovary contains the egg that is at the correct stage of development at the bespeak in time at the time of ovulation and is nothing to practice with a set pattern.
The side nosotros ovulate from does not strictly thing as an egg from one ovary tin travel down the Fallopian tube on the other side.
How can I tell if I am ovulating?
The menstrual bike lasts well-nigh 28 days for almost and ovulation ordinarily happens 10 to 16 days earlier the start of your side by side period. When you're ovulating, you are at your most fertile so information technology is the all-time time of the calendar month to have sex activity. Physical signs of ovulation include an increase in vaginal discharge. This changes from white, flossy or non-existent to clear, stretchy and slippery (like egg-white consistency) when you ovulate.
How can an egg travel downwards the merely Fallopian tube I accept when it is produced on the other side from the ovary where I have no Fallopian tube?
The Fallopian tubes and uterus are lined with little receptor cells that, at the bespeak of ovulation, are sent a chemical signal that 'switches' them on and they emit a signal that attracts a similar receptor in the egg and in the sperm to come up and meet in the same identify, i.e. the Fallopian tube. The Fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae on the end of the Fallopian tube begin to move gently cartoon the egg toward the finish of the Fallopian tube (like lots of picayune fingers waving and drawing the egg towards information technology).
Can my Home Pregnancy Test (HPT) tell me if I am ovulating and can my Ovulation Predictor Kit (OPK) tell me if I am meaning?
The Deoxyribonucleic acid that makes up the strands for hCG, which is the hormone associated with pregnancy, is simply i strand unlike to the luteinising hormone (LH) which detects ovulation. Both hormones, at a molecular level, are almost identical. hCG has a beta sub-unit of measurement, meaning that it has an extra molecular twist. This means that information technology is possible for an OPK to detect pregnancy, although this is non ever reliable. It is not, however, possible to utilise an HPT to detect ovulation.
Can a menstrual bike tracking app assistance while trying to excogitate?
Using a mobile computing app to rails menstrual cycles and the fertile window is condign increasingly popular while trying to conceive and may exist suitable for some people. A study looked at various apps that are used to rail the menstrual bike and analysed whether they helped influence chances of formulation. The written report showed that the use of such apps was associated with increased chances of formulation ranging from 12% to twenty% per wheel of attempt.
Lifestyle related questions
Does drinking alcohol affect fertility?
Alcohol affects fertility by disrupting the frail residue of the menstrual bicycle. Clinical research data suggests that women, who drank socially, ane-5 drinks per week, were at a greater chance of decreased fertility when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.
The National Constitute for Health and Clinical Excellence (Squeamish) looks at the available testify on the best fashion of treating or managing a condition and makes recommendations based on evidence. Doctors, nurses and other healthcare professionals in the NHS are expected to follow NICE's clinical guidelines. Current NICE guidance states:
"Pregnant women and women planning a pregnancy should be advised to avoid drinking booze in the first 3 months of pregnancy if possible because it may be associated with an increased risk of miscarriage."
Research also suggests that alcohol disrupts the hormonal imbalance of the female person reproductive organisation, leading to menstrual irregularities, and fifty-fifty anovulatory cycles (menstrual cycles where ovulation fails to occur). These changes tin drastically decrease the chances of becoming meaning and thus touch fertility. The NHS website provides data on drinking booze while pregnant and states that the safest approach is not to drinkable while significant.
Does smoking affect fertility?
It tin exist difficult to end smoking cigarettes but if you lot are thinking of trying to conceive, this is one of the best things that you tin practice. Evidence shows that smoking impacts both male and female fertility.
According to NICE Guidance on Fertility Problems, for men, in that location is a link between smoking and poorer semen quality. Stopping smoking volition improve your general health. Smoking is also probable to reduce fertility. Animate in someone else's cigarette smoke (passive smoking) is as well likely to reduce the chances of getting significant.
Research from Edinburgh University has found that a chemical found in cigarette smoke (Cotinine) triggers a reaction which increases a poly peptide in the Fallopian tubes. This poly peptide, called PROKR1 raises the chance of an egg implanting exterior the womb, leading to an ectopic pregnancy.
If you smoke, your doctor/GP should offer you aid to stop if yous wish. The NHS Smoking Helpline can also provide communication and support via phone and the website.
Is there anything I can do to guarantee my chances of conception next time?
Unfortunately, nothing tin can guarantee a pregnancy, but if you have a history of abdominal hurting which continues later on the ectopic pregnancy, you should see your doctor/GP to brand certain you do non accept a persistent infection that might touch future fertility. Having regular sexual intercourse is a good manner to approach future conception.
I have read about alternative therapies and supplements for fertility - practice these work?
The EPT is a charity that has the backing of medical specialists and prides itself in providing accurate, enquiry-based medical information. While we sympathise that many people are interested in the employ of alternative and complementary therapies, nosotros do not endorse these on our site.
We, therefore, remind yous that, should yous wish to make utilize of these therapies, y'all exercise caution and avert recommending them to users of the EPT forums. Many complementary medicines are powerful and can take harmful side effects if misused. They may as well interact with medicines that y'all may already be taking or intend to take. Please remember that "natural" does not ever mean prophylactic – indeed some of the medicines that are prescribed today (including some controlled drugs) are derived from natural products. Many "natural" or "herbal" preparations tin interfere with prescribed medicines or even make an existing status or illness worse.
Buying medicines on the internet is far from prophylactic and yous can never exist 100% sure that they exercise what they say they do or contain what they say they do. Unfortunately, there are unscrupulous people who have no issues with making money from vulnerable groups of people (like those who are trying to conceive or who have suffered a loss), making claims that cannot exist substantiated about products and services they aim to supply. Delight do be aware of this and seek guidance and or alternative treatment only from appropriately qualified and registered individuals.
Testing related questions
What tests, treatments, or investigations can be carried out to ensure an ectopic pregnancy volition not happen again?
Sadly, there are no tests or investigations that tin be done to clinch you that yous volition not experience an ectopic pregnancy once again. Ectopic pregnancy occurs because of some underlying damage to a Fallopian tube and the cause of this damage may never be established. Assisted reproductive techniques, like IVF treatment where the embryo is placed in the uterus, can also result in an ectopic pregnancy and unfortunately and so is not a guaranteed fashion of ensuring information technology will never happen once again. Doctors would usually desire you to look to try again for three months, subsequently which, your medico volition probably encourage yous to try again for 12 months if you are less than 35 or 6 months if you are over 35. Just if yous practice non excogitate within those times would they then consider further tests and investigations. The exception to this might exist if the surgeon saw something during the surgical procedure to resolve your ectopic pregnancy that they felt warranted farther investigation more speedily.
If you feel that you may take ongoing issues of pelvic infection, you can take a chlamydia test. Chlamydia is unremarkably symptomless and if left untreated, the infection can spread to other parts of your body and lead to long-term health issues, such as pelvic inflammatory disease (PID) and infertility. Testing for and taking antibody treatment if required might help to reduce the take chances of these problems.
I have been referred for a tubal patency exam. What is it?
A tubal patency test might be available if you have been trying to excogitate for a year and are not pregnant if you are nether the historic period of 35, or six months if y'all are over the historic period of 35. Y'all should visit your health care provider to discuss this.
Hysterosalpingography (HIS-tur-oh-sal-ping-GOG-ru-fee) or HSG exam is a procedure to investigate the shape of the uterine cavity and the shape and patency (the state of not being blocked or obstructed) of the Fallopian tubes. The test involves having a speculum exam like a during a smear test and an x-ray of the uterus and the Fallopian tubes. The doctors inject a special radiographic dye into the uterine crenel through the vagina and cervix which shows upwardly on the x-ray. They then watch to see if the dye moves freely through the uterus and Fallopian tubes to look for a block that may exist causing fertility problems. Hysterosalpingo Contrast Sonography (HyCoSy) is a similar process using ultrasound. If the Fallopian tubes are open, the special dye will fill up the tubes and spill out into the abdominal cavity. If the Fallopian tubes are full or partially blocked the dye will not flow freely and whether the blockage is located at the junction of the Fallopian tube and the uterus (proximal) or whether it is at the end of the Fallopian tube (distal) can also be adamant.
People are able to attempt to conceive again during their side by side menstrual cycle after a tubal patency examination unless medical professionals suggest a longer wait time. It has been claimed that pregnancy rates are increased in a cycle when a tubal patency test has been performed.
What are the limitations with a tubal patency test?
Unfortunately, tubal patency tests cannot provide consummate peace of mind. Even if a tubal patency test shows an open Fallopian tube, it does non testify whether it will work – only a normally located pregnancy can show that at to the lowest degree one Fallopian tube worked.
The test is not 100% accurate as the Fallopian tubes can go into spasm during the test and can appear blocked fifty-fifty though this is non the case. This can cause unnecessary anxiety if the Fallopian tube is affected by spasm but in face up is really working normally.
The test cannot determine what the internal villi of the Fallopian tube look like.
The tubal patency test can be painful, so analgesics (hurting relief) may be administered before and/or after the procedure to reduce hurting. Many doctors will also prescribe an antibiotic prior to the procedure to reduce the pocket-sized gamble of an infection. Medical professionals prescribe the antibiotics taking the viewpoint that prevention is meliorate than cure and it is ameliorate to foreclose an infection in your Fallopian tubes rather than cure it.
There is a 1% chance of getting an infection from a tubal patency test and, of that 1% adventure of infection, only 20% of the 1% who go an infection would need hospitalisation. This means that there is a 99.eight% chance of not causing damage to a Fallopian tube and a 0.2% chance of damage.
Information technology would be probable that you would know if you got an infection through symptoms like: abnormal vaginal discharge, painful menstrual periods, painful or uncomfortable sexual intercourse, abdominal pain affecting both sides, frequent urination, spotting between periods, pain during ovulation, fever, and/or lower back hurting.
My doctor says I practise non need to accept a tubal patency exam. Why?
Doctors prefer not to utilise a tubal patency test unless they actually need to considering it is non a 100% authentic exam. For example, if the Fallopian tubes go into spasm during the test they can announced blocked even though this is not the case. The examination can too non determine what the internal villi of the Fallopian tube look like. Furthermore, it is an invasive test and in that location is a small (1%) chance that it can cause infection of the Fallopian tubes hence their preference to only perform the exam when it is unquestionably required.
When an ectopic pregnancy is treated, the remaining Fallopian tube is typically examined externally and the doctors would usually accept told yous if they had seen any problems with it at that time. If you lot would like peace of mind almost this y'all could enquire for a post-operative follow up appointment to ask whether they had looked at the condition of your Fallopian tubes during the operation. Yous tin can also request a re-create of your medical notes for your operation.
The examination is a pretty good indicator about the condition of your remaining Fallopian tube(s) because it looks at:
The fimbriae – The Fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very fragile structures called the fimbriae begin to motion gently creating a slight vacuum to suck the egg toward the end of the Fallopian tube information technology is nearest to (like lots of footling fingers waving and drawing the egg towards it).
- Whether in that location are whatever adhesions (scar tissue)
- Whether there is any thickening of the Fallopian tube
- The shape of the Fallopian tube
What is selective salpingography?
Selective salpingography is not bachelor in every centre but is well documented as having good success rates. It is normally done under balmy sedation with pain relief.
During a tubal patency examination, a pocket-sized diameter flexible catheter is threaded inside the catheter and, with the help of the x-ray machine, tin can exist directed right into the opening of the Fallopian tube. In one case this is done, dye can be introduced direct into the Fallopian tube. With this technique, it is possible to demonstrate a normal, patent Fallopian tube whose opening may be in spasm. Fallopian tubes with an obstruction tin also be opened by the college pressures which can be achieved with selective salpingography.
Assisted formulation related questions
What is Clomid?
Clomiphene or Clomid is an extremely powerful, oral (taken by mouth), medication that is often prescribed to help those trying to become significant if their menstrual (period) bicycle is then irregular that they cannot be sure when or if they are ovulating. The Clomid would produce a regular cycle to permit for timed intercourse or intrauterine insemination. The medication works by blocking estrogen receptors in the brain, stimulating them to release Follicle Stimulating Hormone (FSH), and Luteinizing Hormone (LH). These are the naturally occurring ovarian stimulants that prompt ovulation in a normal cycle.
Typically, you will have one to iii tablets a day for five days early in your bike. During this time, some will find hot flashes, moodiness, or sleep blueprint changes just most find no symptoms at all. Ovulation will typically occur vii-8 days following completion of the Clomid handling. Because the ovaries are stimulated at that place may be some bloating, or discomfort with intercourse.
The chance of multiple ovulations is slightly higher with Clomid than with a normal menstrual bike. The chance of twins resulting from Clomid is 6-eight%. There is no increased take chances of higher order multiples (triplets, etc).
Rarely hyperstimulation of the ovaries can occur as a result of Clomid utilise. In this case the ovaries become enlarged with multiple follicles. Other rare side furnishings include visual changes, reversible hair thinning, dizziness, or hives. People with currently existent large ovarian cysts or liver affliction should not use Clomid.
Am I able to become significant with no Fallopian tubes?
If your Fallopian tubes were removed or both have been deemed completely blocked, it is nevertheless possible to become pregnant with IVF considering it bypasses the Fallopian tube and the embryos are placed straight into the uterus.
In 2018, the percentage of IVF treatments that resulted in a live birth per wheel started were:
33.0% for women under 35
27.7% for women aged 35-37
22.v% for women aged 38-39
15.0% for women aged 40-42
6% for women aged 43-44
4.0% for women aged over 44
What are the NHS criteria for being eligible for IVF?
The NHS website summarises that, in 2013, the National Institute for Health and Care Excellence (NICE) published guidelines nigh who should take access to IVF handling on the NHS in England and Wales. These guidelines were updated in 2017.
According to the guidelines, women anile under 40 should be offered three cycles of IVF handling on the NHS if they take been trying to get pregnant through regular unprotected intercourse for two years, or have not been able to become pregnant after 12 cycles of artificial insemination (directly inserting sperm into the womb). The guideline also states that if tests bear witness IVF is the only treatment likely to aid yous become significant, you should be referred for IVF straight away. If you turn twoscore during treatment, the current bicycle volition be completed, simply further cycles should not exist offered.
For women anile forty to 42, the guidelines also say women should be offered 1 cycle of IVF on the NHS if they take been trying to get pregnant through regular unprotected intercourse for two years, or have not been able to go pregnant after 12 cycles of bogus insemination; They have never had IVF treatment earlier; They show no evidence of a shortage of eggs and they have been informed of the boosted implications of IVF and pregnancy at this age. Again, if tests prove IVF is the merely handling likely to aid you get significant, yous should exist referred for IVF straight away.
The reality is somewhat different to this guideline though and NHS trusts across England and Wales offer dissimilar levels of service. The provision of IVF treatment varies across the country and ofttimes depends on local policies.
Priority is often given to couples who do not already have children and this tin can sometimes exist hard when yous do not have a baby but you are told yous are non eligible considering your partner has a kid from a previous relationship. Sometimes people are also advised to lose weight in order to be eligible for IVF as this increases the likelihood of successful treatment.
Pregnancy examination questions
I feel pregnant but my domicile pregnancy test is negative. Why is this?
There tin be a number of reasons for this:
As the hormones in our bodies change in the afterwards stages of the menstrual bicycle, a special cyst called the corpus luteum cyst stimulates an ovary to produce progesterone. Progesterone has many actions on the body merely, along with the other changes in your torso, it tin can exit you lot feeling swollen, with tender breasts and sometimes feeling headachy and nauseated (sick). These can sometimes exist interpreted as the feelings you lot might become in early pregnancy and can leave you feeling disappointed when a period arrives a few days late.
Sometimes ovulation tin occur later in the cycle than twenty-four hour period 14. This might especially be the case if you unremarkably have cycles which are longer than 28 days. If you ovulate later in the cycle, the egg may not have implanted for as long as necessary to produce the hCG hormone which is what a habitation pregnancy test detects.
Sometimes it can take longer than the average half dozen to seven days for the egg to travel along the Fallopian tube and implant. Where this happens, the egg may non have implanted for as long as necessary to produce the hCG hormone which is what a home pregnancy test detects.
The test may exist from a faulty batch.
My habitation pregnancy test was negative to brainstorm with but at present seems to be positive. What should I practice?
Dwelling pregnancy tests must exist read within the time frame specified in the private instructions on each pack. These times vary a little only any result which appears after 10 minutes cannot be relied upon to be an accurate issue. Information technology is non unheard of for people to practice a exam which is negative, leave it on the bathroom window sill until sometime later, and then when they look at information technology again a new line has appeared in the exam window. This is invariably an evaporation line and not a positive effect.
To become an accurate result, information technology is essential you follow the instructions on the Home Pregnancy Test pack. You should preferably exam with the beginning urine of the 24-hour interval and in urine which has been in your bladder for at least 4 hours. Finally, you should e'er read the test result within the time frame clearly stated on the exam pack's instructions.
My abode pregnancy test is positive only my doctors examination is negative. Why is this?
If the examination is done in the surgery using a reagent stick, just similar the habitation pregnancy test you have already washed, there is the possibility that the test the dr. is using is not equally sensitive as your home pregnancy test.
Sometimes ovulation occurs subsequently in the menstrual cycle than day xiv. This might peculiarly be the case if you normally take cycles which are longer than 28 days. If you ovulate later in the cycle, the egg may not have implanted for every bit long as necessary to produce the hCG hormone which is what a pregnancy test detects.
Sometimes it can take longer than the average 6 to 7 days for the egg to travel along the Fallopian tube and implant. Where this happens, the egg may not have implanted for as long as necessary to produce the hCG hormone which is what a dwelling pregnancy test detects.
The test may be from a faulty batch.
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If you or someone you know needs back up with an ectopic pregnancy, please feel gratis to contact u.s.a..
Other pages yous might find helpful
Learn more about post ectopic pregnancy pain during recovery
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Source: https://ectopic.org.uk/physical-recovery/trying-to-conceive-again
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