Q: I just had emergency surgery because of an ectopic pregnancy (my fallopian tube burst) and I’d like to try to conceive again once my body recovers. What can I do to improve my chances of getting pregnant and carrying the baby to term? Can an ectopic pregnancy be diagnosed very early?
A: An ectopic pregnancy is devastating, not only for the loss of the pregnancy and the emergency surgery that may be needed, but also because it can impair fertility. Also called tubal pregnancies, ectopic pregnancies – in which a fertilized egg implants itself outside the uterus – are usually found in the fallopian tubes, although they are occasionally found in the ovaries, abdominal cavity, or cervix. If not detected in time, an egg developing in the fallopian tube will cause the tube to burst, and the tube usually must be removed surgically.
Once your doctor has given you the go-ahead, you can try to get pregnant again. S-X won’t harm abdominal stitches or your reproductive organs. Unfortunately, the fact that you’ve had one ectopic pregnancy does put you at risk for another. But you needn’t worry that a future such pregnancy will result in another burst fallopian tube; early-stage ectopic pregnancies can be treated with laparoscopic surgery, or a combination of drugs that dissolve the pregnancy.
As soon as you suspect you might be pregnant – once your period is a day late – schedule a blood test. Ectopic pregnancies can be diagnosed very early with a test for the hormones HcG and progesterone, along with an ultrasound exam to determine exactly where the pregnancy is. If you experience any unexplained bleeding or spotting, tell your doctor right away. And, as you know, a sharp abdominal pain that comes on suddenly, dizziness, fainting, or shock can also signal a ruptured fallopian tube.
Although ectopic pregnancies are linked to fertility problems, most fertility specialists recommend trying to conceive for six months before moving on to in-depth evaluation and treatment. In vitro fertilization and other high-tech treatments can make pregnancy more likely since the embryo is surgically implanted in the uterus, bypassing the fallopian tubes.
The following specialists from the University of California at Los Angeles Medical Center contributed to this column:
Alan DeCherney, M.D., chair, obstetrics and gynecology; Greg Fonarow, M.D., professor, cardiology; Gary Gitnick, M.D., chief, division of digestive diseases; and David Heber, M.D., professor and chief of clinical nutrition, and director of center for human nutrition.