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Going through an ectopic pregnancy can be terrifying, and you may also have fears about your future fertility. Here's what you need to know about trying to conceive after a tubal or other ectopic pregnancy.

An ectopic pregnancy is a pregnancy that develops outside of the uterus, most commonly in one of the fallopian tubes, but also sometimes in an ovary or in the abdominal cavity. 

An Overview Of Tubal Pregnancy

Ectopic pregnancy most commonly occurs in the fallopian tubes, where eggs are normally fertilized, and it usually happens because the fallopian tube was damaged in some way.
Risk factors include:
  • Pelvic Inflammatory Disease (PID), which is a bacterial infection of the reproductive system, most commonly chlamydia.
  • Women with a previous history of ectopic pregnancy are more likely to have an ectopic pregnancy again.
  • Any surgery that involves the fallopian tubes leads to a higher risk of tubal pregnancy.
  • Intrauterine devices represent a very effective form of birth control, but if it fails the pregnancy is more likely to be ectopic.
  • Rarely ectopic pregnancy can result as one of the side effects of tubal ligation

Other risk factors include smoking and being over 35. 

An ectopic pregnancy wil normally produce your typical pregnancy symptoms — including a positive pregnancy test — in the initial stages. Later, symptoms that point to something wrong include pain and cramps in the lower abdomen, light vaginal bleeding, nausea and vomiting. Tubal pregnancies are not viable pregnancies, and if they are not treated in a timely manner, an ectopic pregnancy may rupture the fallopian tubes, resulting in hemorrhage. Symptoms of rupture include fainting shock and light headedness. It is a very dangerous complication and requires emergency surgery.
Diagnosis is made by looking at the patient's medical history, performing a clinical exam and doing an ultrasound. The scan shows no fetus or gestational sac inside the uterine cavity.

Tubal Pregnancy Treatment

Treatment depends on the size of the fetal and placental tissue. In the early stages of pregnancy, methotrexate can be offered to reduce the size of the tissue and ultimately to make it disappear. Surgery is required to remove the ectopic tissue after making a hole in the tube (Salpingostomy) in more advanced pregnancies. If the tissue is very large and extensively attached to the fallopian tube, a part of the tube is removed surgically along with the ectopic tissue (Salpingectomy)

Two fears are common among patients: the chance of experiencing another ectopic pregnancy, and infertility. There is a good chance of having another ectopic pregnancy because the reason which caused the first ectopic pregnancy is usually still present. The damage to fallopian tubes is further increased after ectopic pregnancy.

Infertility is also a fear but the chances depend on the condition of the fallopian tubes and therefore it varies in different patients. In general, most patients do get pregnant after some time. If the patient gets pregnant again, careful monitoring is necessary to rule out another ectopic pregnancy

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