If You Have One Ectopic Pregnancy Will It Happen Again
Trying to Conceive Again
Explaining Ectopic Pregnancy: Trying to conceive again (with subtitles)
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If you or someone yous know needs support with an ectopic pregnancy, please experience complimentary to contact united states.
Answering your questions on conceiving after an ectopic pregnancy
Information technology is probable you take been advised to wait for 3 months if you have had methotrexate, or for two full menstrual cycles (periods) subsequently surgery or expectant direction, earlier trying to conceive. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is non your first period. Information technology is the bleed that occurs in response to falling hormones associated with the lost pregnancy.
Statistically, the chances of having a hereafter successful pregnancy are very good and 65% of women are healthily significant within 18 months of an ectopic pregnancy. Some studies propose this figure rises to effectually 85% over two years. The time it takes to conceive and chances of conceiving depends on many factors such as the health of your Fallopian tube(south), historic period, your general and reproductive health and how oft you take sex.
Detailed full general data can exist institute here on our website. Please remember that online medical information is no substitute for skilful medical intendance from your ain healthcare team.
Beneath is a list of common questions that nosotros are asked about trying to conceive. This page covers questions on timing, ovulation, lifestyle, testing, assisted conception, and pregnancy tests.
Fourth dimension related questions
Why must I wait for three months earlier trying to excogitate?
While there is no clear, researched evidence on how long a couple should wait to try to conceive later on having handling for ectopic pregnancy, we and other medical professionals advise that information technology may be best to wait for at least three months or 2 full menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The drain that occurs in the starting time calendar week or then of handling for an ectopic pregnancy is not your beginning period. It is the drain that occurs in response to falling hormones associated with the lost pregnancy.
Physically, this timeframe is to let your cycle to return to normal and for in that location to be a articulate period to date a new pregnancy from. The date of the outset 24-hour interval of the period is what is used to decide when to scan a new pregnancy; information that is invaluable in ensuring you are not suffering from another ectopic pregnancy.
The first proper period y'all have subsequently an ectopic pregnancy may exist heavier than usual and the second more than like your usual menstruum. A normal menses would advise you are hormonally fix to be able to endeavour to conceive. Having two periods can also give an idea of menstrual cycle length, which may exist different for a few months after your ectopic before settling dorsum into its usual rhythm.
This look allows the internal inflammation and bruising from the ectopic and any associated treatment to heal.
In add-on to the physical aspects of ectopic pregnancy, many people also experience an intense emotional bear upon. Taking time before trying to conceive over again enables the necessary process of grief to surface and be worked through. The emotional recovery that is oft needed can exist 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 have fallen to below 5mIU/mL (your doctor will advise you when this is through blood or urinary tests) and then take a folic acrid supplement for 12 weeks before you lot effort to excogitate.
This is because the drug may have reduced the level of folate in your trunk which is needed to ensure a baby develops healthily. The methotrexate is metabolised quickly but it tin can impact the quality of your cells, including those of your eggs, and the quality of your blood for up to 3 months after it has been given. The medicine can also affect the way your liver works and then you demand to give your torso fourth dimension to recover properly earlier a new pregnancy is considered. A shortage of folate could outcome in a greater chance of a baby having a neural tube defect such as scissure lip and palate, or even spina bifida or other neural tube defects.
If you have had medical direction followed by surgery, you tin kickoff taking a folic acrid supplement over again one time your doctors take confirmed that all of the pregnancy has resolved. This is particularly important if you accept been having blood tests to check hCG levels later on your surgery. You tin start to try to conceive again 12 weeks subsequently the date that the methotrexate was administered.
The NHS website has more data on vitamins, supplements, and nutrition during pregnancy.
Ovaluation related questions
When will I ovulate over again?
Before your starting time period arrives, you volition ovulate. The menstruum when it returns volition indicate that you lot are ovulating over again. It is possible to ovulate fourteen days afterward surgical handling and during methotrexate treatment, so it is important to be enlightened that it is possible to go meaning without having a menses first, if you lot are not using some form of contraception.
Take I only got half of my fertility?
When a person has simply 1 Fallopian tube, they are still able to get pregnant from an egg released by the opposite ovary equally an egg from one ovary tin travel down the Fallopian tube on the other side. Approximately one-third of pregnancies are a result of pick-upward of the egg from the ovary on the opposite side to the remaining Fallopian tube. It may be reassuring to know that when you ovulate from the ovary by the removed Fallopian tube which is opposite to the remaining Fallopian tube, information technology is not a 'wasted' wheel.
What do ovulation kits predict?
An ovulation predictor kit measures Luteinising Hormone (LH). A surge in LH leads to ovulation within the side by side 12 hours. The egg does not always get released from the ovary in spite of a surge but it is a very good mark. A positive pregnancy exam effectually 14 days later on yous recall ovulation occurred is the only way of establishing that it actually did.
Urinary ovulation predictor kits are used typically daily around the time ovulation may be expected. A conversion from a negative to a positive reading would advise that ovulation is about to occur inside 24–48 hours, giving 2 days to engage in sexual intercourse or artificial insemination with the intention of conceiving.
As sperm tin can stay feasible in the female reproductive organisation for several days, LH tests are non recommended for contraception, as the LH surge typically occurs after the beginning of the fertile window.
Is it truthful that I ovulate on alternating sides each month?
We naturally presume that we will ovulate from alternative ovaries each month (left ovary, correct ovary, left, right 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 volition 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 ane gives upwards (only not always – sometimes ovulation occurs from both ovaries in 1 bicycle or twice from 1 ovary – this explains how we get non-identical twins naturally). It depends on which ovary contains the egg that is at the right phase of development at the point in time at the time of ovulation and is nothing to practise with a fix pattern.
The side we ovulate from does not strictly matter equally an egg from 1 ovary can travel down the Fallopian tube on the other side.
How tin I tell if I am ovulating?
The menstrual wheel lasts about 28 days for virtually and ovulation commonly happens x to 16 days earlier the get-go of your next period. When you're ovulating, you are at your most fertile then information technology is the best fourth dimension of the month to have sex. Physical signs of ovulation include an increase in vaginal discharge. This changes from white, creamy or non-existent to articulate, stretchy and glace (like egg-white consistency) when you ovulate.
How can an egg travel downwards the only Fallopian tube I have 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 signal of ovulation, are sent a chemical indicate that 'switches' them on and they emit a signal that attracts a similar receptor in the egg and in the sperm to come and meet in the same identify, i.east. 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 stop of the Fallopian tube brainstorm to move gently cartoon the egg toward the stop of the Fallopian tube (like lots of little fingers waving and cartoon the egg towards information technology).
Can my Abode Pregnancy Test (HPT) tell me if I am ovulating and can my Ovulation Predictor Kit (OPK) tell me if I am pregnant?
The Dna that makes up the strands for hCG, which is the hormone associated with pregnancy, is but 1 strand dissimilar to the luteinising hormone (LH) which detects ovulation. Both hormones, at a molecular level, are nearly identical. hCG has a beta sub-unit, meaning that it has an actress molecular twist. This means that information technology is possible for an OPK to observe pregnancy, although this is not ever reliable. It is non, however, possible to use an HPT to notice ovulation.
Can a menstrual cycle tracking app help while trying to conceive?
Using a mobile computing app to track menstrual cycles and the fertile window is becoming increasingly popular while trying to conceive and may be suitable for some people. A study looked at various apps that are used to track the menstrual bicycle and analysed whether they helped influence chances of formulation. The study showed that the employ of such apps was associated with increased chances of conception ranging from 12% to 20% per cycle of attempt.
Lifestyle related questions
Does drinking alcohol touch fertility?
Alcohol affects fertility by disrupting the fragile balance of the menstrual bike. Clinical research information suggests that women, who drank socially, 1-5 drinks per week, were at a greater take a chance of decreased fertility when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to excogitate.
The National Institute for Health and Clinical Excellence (NICE) looks at the bachelor bear witness on the all-time way 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 Squeamish'southward clinical guidelines. Current NICE guidance states:
"Pregnant women and women planning a pregnancy should be advised to avert drinking alcohol in the kickoff iii months of pregnancy if possible considering it may be associated with an increased gamble of miscarriage."
Research as well suggests that alcohol disrupts the hormonal imbalance of the female reproductive organisation, leading to menstrual irregularities, and fifty-fifty anovulatory cycles (menstrual cycles where ovulation fails to occur). These changes can drastically decrease the chances of condign pregnant and thus affect fertility. The NHS website provides information on drinking alcohol while pregnant and states that the safest approach is not to drink while significant.
Does smoking touch fertility?
It tin can be hard to stop smoking cigarettes just if yous are thinking of trying to conceive, this is i of the best things that you can do. Testify shows that smoking impacts both male and female person fertility.
Co-ordinate to Prissy Guidance on Fertility Problems, for men, there is a link between smoking and poorer semen quality. Stopping smoking volition improve your general wellness. Smoking is also likely to reduce fertility. Breathing in someone else's cigarette smoke (passive smoking) is also likely to reduce the chances of getting pregnant.
Research from Edinburgh Academy has found that a chemical constitute in cigarette smoke (Cotinine) triggers a reaction which increases a poly peptide in the Fallopian tubes. This protein, chosen PROKR1 raises the take a chance of an egg implanting exterior the womb, leading to an ectopic pregnancy.
If you smoke, your doctor/GP should offer you assistance to end if you wish. The NHS Smoking Helpline can also provide advice and support via phone and the website.
Is there annihilation I can practise to guarantee my chances of conception next fourth dimension?
Unfortunately, nix can guarantee a pregnancy, but if you accept a history of intestinal pain which continues after the ectopic pregnancy, y'all should encounter your doctor/GP to brand certain you lot do not accept a persistent infection that might touch future fertility. Having regular sexual intercourse is a skillful mode to arroyo future formulation.
I accept read virtually alternative therapies and supplements for fertility - do 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 you wish to make use of these therapies, you exercise caution and avoid recommending them to users of the EPT forums. Many complementary medicines are powerful and can have harmful side furnishings if misused. They may also collaborate with medicines that you may already be taking or intend to have. Please recall that "natural" does not always hateful safe – indeed some of the medicines that are prescribed today (including some controlled drugs) are derived from natural products. Many "natural" or "herbal" preparations can interfere with prescribed medicines or even make an existing status or illness worse.
Buying medicines on the cyberspace is far from safety and yous tin can never be 100% sure that they do what they say they do or comprise what they say they do. Unfortunately, at that place are unscrupulous people who have no issues with making money from vulnerable groups of people (like those who are trying to conceive or who take suffered a loss), making claims that cannot be substantiated about products and services they aim to supply. Please practise be aware of this and seek guidance and or culling treatment just from appropriately qualified and registered individuals.
Testing related questions
What tests, treatments, or investigations can be carried out to ensure an ectopic pregnancy will not happen again?
Sadly, at that place are no tests or investigations that can exist done to clinch y'all that you will not experience an ectopic pregnancy again. Ectopic pregnancy occurs considering of some underlying damage to a Fallopian tube and the cause of this impairment may never exist established. Assisted reproductive techniques, like IVF treatment where the embryo is placed in the uterus, tin can besides event in an ectopic pregnancy and unfortunately so is non a guaranteed manner of ensuring it will never happen over again. Doctors would unremarkably want you to await to endeavour once again for iii months, after which, your physician will probably encourage you to try once more for 12 months if you are less than 35 or six months if you are over 35. Only if yous do not excogitate within those times would they and then consider farther tests and investigations. The exception to this might exist if the surgeon saw something during the surgical process to resolve your ectopic pregnancy that they felt warranted further investigation more quickly.
If you experience that you may have ongoing problems of pelvic infection, you can take a chlamydia test. Chlamydia is usually symptomless and if left untreated, the infection can spread to other parts of your body and lead to long-term health problems, such as pelvic inflammatory affliction (PID) and infertility. Testing for and taking antibody handling if required might aid to reduce the hazard of these bug.
I have been referred for a tubal patency test. What is it?
A tubal patency exam might be available if you have been trying to conceive for a yr and are not meaning if you lot are under the age of 35, or six months if you are over the historic period of 35. You lot should visit your wellness care provider to discuss this.
Hysterosalpingography (HIS-tur-oh-sal-ping-GOG-ru-fee) or HSG test is a procedure to investigate the shape of the uterine cavity and the shape and patency (the country of non being blocked or obstructed) of the Fallopian tubes. The test involves having a speculum examination 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 cavity through the vagina and cervix which shows upwards on the x-ray. They and then sentinel to see if the dye moves freely through the uterus and Fallopian tubes to look for a block that may be causing fertility problems. Hysterosalpingo Contrast Sonography (HyCoSy) is a similar process using ultrasound. If the Fallopian tubes are open, the special dye will fill the tubes and spill out into the abdominal cavity. If the Fallopian tubes are full or partially blocked the dye will not period freely and whether the blockage is located at the junction of the Fallopian tube and the uterus (proximal) or whether information technology is at the end of the Fallopian tube (distal) can also be determined.
People are able to attempt to conceive again during their side by side menstrual cycle subsequently a tubal patency examination unless medical professionals propose a longer wait time. It has been claimed that pregnancy rates are increased in a bicycle when a tubal patency test has been performed.
What are the limitations with a tubal patency examination?
Unfortunately, tubal patency tests cannot provide complete peace of mind. Even if a tubal patency test shows an open Fallopian tube, it does not evidence whether information technology will work – only a normally located pregnancy tin can show that at least one Fallopian tube worked.
The test is not 100% accurate as the Fallopian tubes tin go into spasm during the exam and tin can appear blocked even though this is not the case. This can cause unnecessary anxiety if the Fallopian tube is affected past spasm but in face up is actually working normally.
The test cannot decide what the internal villi of the Fallopian tube look like.
The tubal patency test can be painful, and then analgesics (pain relief) may be administered before and/or after the procedure to reduce pain. Many doctors will also prescribe an antibiotic prior to the procedure to reduce the small risk of an infection. Medical professionals prescribe the antibiotics taking the viewpoint that prevention is improve than cure and information technology is better to prevent an infection in your Fallopian tubes rather than cure information technology.
There is a 1% risk of getting an infection from a tubal patency examination and, of that 1% chance of infection, only 20% of the 1% who get an infection would need hospitalisation. This means that there is a 99.8% chance of not causing harm to a Fallopian tube and a 0.2% take chances of damage.
It would exist likely that you lot would know if you got an infection through symptoms like: aberrant 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 pain.
My dr. says I practise not demand to have a tubal patency examination. Why?
Doctors prefer not to use a tubal patency test unless they really demand to because information technology is not a 100% accurate test. For instance, if the Fallopian tubes go into spasm during the test they can appear blocked even though this is not the instance. The test can besides non decide what the internal villi of the Fallopian tube expect like. Furthermore, it is an invasive examination and there is a pocket-sized (1%) chance that information technology can cause infection of the Fallopian tubes hence their preference to only perform the test when it is unquestionably required.
When an ectopic pregnancy is treated, the remaining Fallopian tube is typically examined externally and the doctors would usually have told you if they had seen any problems with information technology at that fourth dimension. If you would like peace of mind most this you lot could ask for a post-operative follow up appointment to ask whether they had looked at the condition of your Fallopian tubes during the operation. You can besides asking a copy of your medical notes for your functioning.
The exam is a pretty good indicator about the status of your remaining Fallopian tube(southward) because it looks at:
The fimbriae – The Fallopian tubes are not fastened to the ovaries and, at the indicate of ovulation, some very delicate structures called the fimbriae begin to motion gently creating a slight vacuum to suck the egg toward the stop of the Fallopian tube information technology is nearest to (like lots of petty fingers waving and cartoon the egg towards it).
- Whether there are whatever adhesions (scar tissue)
- Whether there is whatsoever thickening of the Fallopian tube
- The shape of the Fallopian tube
What is selective salpingography?
Selective salpingography is not available in every centre but is well documented equally having good success rates. It is ordinarily done under mild sedation with hurting relief.
During a tubal patency examination, a pocket-sized diameter flexible catheter is threaded inside the catheter and, with the assistance of the ten-ray machine, can be directed right into the opening of the Fallopian tube. Once 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 exist in spasm. Fallopian tubes with an obstruction can also be opened past the higher pressures which tin exist achieved with selective salpingography.
Assisted conception related questions
What is Clomid?
Clomiphene or Clomid is an extremely powerful, oral (taken by oral fissure), medication that is often prescribed to help those trying to go pregnant if their menstrual (period) cycle is so irregular that they cannot exist sure when or if they are ovulating. The Clomid would produce a regular bicycle to allow 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 take one to three tablets a day for five days early in your bike. During this fourth dimension, some will notice hot flashes, moodiness, or sleep pattern changes but most observe no symptoms at all. Ovulation will typically occur vii-8 days following completion of the Clomid treatment. Because the ovaries are stimulated there may be some bloating, or discomfort with intercourse.
The take chances of multiple ovulations is slightly higher with Clomid than with a normal menstrual cycle. The chance of twins resulting from Clomid is vi-8%. At that place is no increased adventure of higher order multiples (triplets, etc).
Rarely hyperstimulation of the ovaries can occur as a consequence of Clomid use. In this instance the ovaries become enlarged with multiple follicles. Other rare side effects 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 get pregnant with no Fallopian tubes?
If your Fallopian tubes were removed or both accept been deemed completely blocked, information technology is nevertheless possible to get significant with IVF considering it bypasses the Fallopian tube and the embryos are placed directly 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
22.5% for women aged 38-39
15.0% for women anile 40-42
half-dozen% for women aged 43-44
4.0% for women aged over 44
Reference: Human Fertilisation and Embryology Authority, June 2020
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 near who should have access to IVF handling on the NHS in England and Wales. These guidelines were updated in 2017.
Co-ordinate to the guidelines, women aged nether forty should be offered 3 cycles of IVF treatment on the NHS if they accept been trying to get pregnant through regular unprotected intercourse for ii years, or have not been able to get pregnant later on 12 cycles of artificial insemination (straight inserting sperm into the womb). The guideline likewise states that if tests show IVF is the only treatment likely to help y'all get significant, you should exist referred for IVF straight away. If you turn 40 during handling, the electric current cycle will be completed, but further cycles should not be offered.
For women anile 40 to 42, the guidelines as well say women should be offered one bike of IVF on the NHS if they have been trying to get pregnant through regular unprotected intercourse for two years, or have not been able to get meaning afterwards 12 cycles of artificial insemination; They have never had IVF treatment earlier; They show no evidence of a shortage of eggs and they take been informed of the additional implications of IVF and pregnancy at this age. Again, if tests show IVF is the merely treatment likely to help you get pregnant, you lot should be referred for IVF straight abroad.
The reality is somewhat different to this guideline though and NHS trusts beyond England and Wales offer dissimilar levels of service. The provision of IVF handling varies across the country and often depends on local policies.
Priority is ofttimes given to couples who practice non already have children and this can sometimes be difficult when you do not have a baby merely you lot are told you are not eligible considering your partner has a child from a previous relationship. Sometimes people are also brash to lose weight in society to be eligible for IVF as this increases the likelihood of successful handling.
Pregnancy examination questions
I feel pregnant but my home pregnancy test is negative. Why is this?
At that place can be a number of reasons for this:
As the hormones in our bodies modify in the after stages of the menstrual cycle, a special cyst called the corpus luteum cyst stimulates an ovary to produce progesterone. Progesterone has many actions on the body but, along with the other changes in your body, it can go out you feeling bloated, with tender breasts and sometimes feeling headachy and nauseated (sick). These can sometimes exist interpreted as the feelings you might go far early pregnancy and can exit you lot feeling disappointed when a period arrives a few days tardily.
Sometimes ovulation tin occur afterwards in the bicycle than day fourteen. This might especially be the case if you normally have cycles which are longer than 28 days. If you ovulate afterward in the cycle, the egg may non accept implanted for as long as necessary to produce the hCG hormone which is what a abode pregnancy test detects.
Sometimes it can take longer than the average 6 to vii days for the egg to travel along the Fallopian tube and implant. Where this happens, the egg may not have implanted for equally long as necessary to produce the hCG hormone which is what a domicile pregnancy examination detects.
The test may be from a faulty batch.
My home pregnancy test was negative to begin with but now seems to exist positive. What should I do?
Home pregnancy tests must be read inside the time frame specified in the individual instructions on each pack. These times vary a little but whatever result which appears later on 10 minutes cannot exist relied upon to be an accurate result. It is non unheard of for people to practise a test which is negative, leave it on the bathroom window sill until sometime later, so when they look at it over again a new line has appeared in the examination window. This is invariably an evaporation line and non a positive result.
To get an accurate result, it is essential yous follow the instructions on the Home Pregnancy Test pack. You should preferably test with the first urine of the solar day and in urine which has been in your bladder for at least 4 hours. Finally, you should always read the test result inside the time frame conspicuously stated on the test pack's instructions.
My home pregnancy test is positive but my doctors test is negative. Why is this?
If the test is done in the surgery using a reagent stick, just like the home pregnancy exam yous have already done, there is the possibility that the test the doctor is using is not equally sensitive as your home pregnancy test.
Sometimes ovulation occurs later in the menstrual cycle than day 14. This might specially be the case if you commonly accept cycles which are longer than 28 days. If you ovulate later in the wheel, the egg may not have implanted for as long as necessary to produce the hCG hormone which is what a pregnancy test detects.
Sometimes it tin can take longer than the average half dozen 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 house pregnancy exam detects.
The examination may be from a faulty batch.
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If you or someone you know needs support with an ectopic pregnancy, delight feel free to contact us.
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Source: https://ectopic.org.uk/physical-recovery/trying-to-conceive-again
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