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Pregnancy After Tubal Ectopic Pregnancy

Getting pregnant after an ectopic

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Getting pregnant after a tubal pregnancy can be difficult and there are risks. Women that have had ectopic pregnancies often have damaged, scarred or blocked tubes.

There are 2 main reasons that fallopian tubes in women that have had ectopics might be abnormal.

  1. The tube was already damaged. Ectopics are often caused by scarred fallopian tubes which cause the early embryo to get stuck in the tube before it reaches the uterus.

  2. Sometimes the fallopian tube was normal until the tubal pregnancy. A tubal pregnancy can cause significant damage to the inner lining of the tube.

Ectopic pregnancy occurs when the fertilized embryo implants on a tissue other than the endometrial lining of the uterus. They are almost always in the fallopian tubes.

How to get pregnant after tubal pregnancy

  1. Wait a few months for the damaged area to heal. Then try on your own - with the understanding that you are at high risk for a repeat tubal pregnancy (see below).
  2. Or, have in vitro fertilization. We put 1 or 2 embryos into the middle of the uterine cavity with a very low risk for ectopic.

Fertility after ectopic pregnancy - chance for a successful pregnancy after a tubal pregnancy

  • Tube sparing surgery for small unruptured ectopics results in open tubes after healing in about 80% of cases.
  • The ratio of intrauterine to recurrent tubal pregnancy is about 6:1 but it rises to about 10:1 if the other tube appears normal.

After one ectopic and a tubal sparing surgery:

  • The subsequent delivery rate is about 55%
  • The recurrent ectopic rate is about 15% (so about 20% of pregnancies are ectopics)
  • The infertility rate is about 30%

If the other tube is absent or blocked:

  • The subsequent delivery rate is about 45%
  • The recurrent ectopic rate is about 20% (so about 30% of pregnancies are ectopics)
  • The infertility rate is about 35%

After 2 or more ectopics and conservative surgery:

  • The subsequent delivery rate is about 25%
  • The recurrent ectopic rate is about 25% (so about 50% of pregnancies are ectopics).
  • The infertility rate is about 50%

As a woman has more and more ectopics, the chances for a live birth delivery (without IVF treatment) become less and less.

IVF after ectopic pregnancy

In vitro fertilization, IVF will be the best option for having a successful pregnancy for many women with a history of tubal damage and one or more ectopic pregnancies.

Our IVF success rates
  • Pregnancy success rates with IVF are excellent in (young) women with tubal problems
  • Tubal pregnancy results from in vitro in only about 3% of cases

What monitoring is needed in a second pregnancy after ectopic pregnancy

  • Any pregnancy after an ectopic needs to be carefully monitored in the early stage to confirm the location.
  • After the missed menstrual period or positive home pregnancy test, blood hCG levels can be done to evaluate whether they are rising at an appropriate rate.
  • By about 5 to 6 weeks of pregnancy transvaginal ultrasound can be done to confirm that there is a gestational sac and yolk sac within the uterine cavity.
  • If that is not seen by six weeks, suspicion should be high for another ectopic
  • Once the pregnancy is confirmed in the uterus, it can be treated normally

Pregnancy after tubal removal

  • Sometimes women will have both fallopian tubes surgically removed
  • This can be due to ectopic pregnancies or other tubal or pelvic problems
  • After the tubes are gone the only way to have a baby is with in vitro fertilization
  • IVF has high success rates for women without fallopian tubes (or with damaged tubes)

Babies who had our help
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