Contraception

Some forms of contraception are not as effective as reducing the risk of ectopic pregnancy as others, but any type of contraception is better than nothing. Your menstrual cycle may not return to normal straight-away and natural methods of cycle tracking are unlikely to be accurate.

Generally speaking, long-acting forms of contraception has the lowest failure rate as you do not have to remember to use it or take it every day. This includes progesterone coils, copper coils, the contraceptive implant, and the contraceptive injection. These are best used if you think that you do not want to conceive for at least a year.  If a contraceptive coil fails, there is a risk that the pregnancy is ectopic, but this risk is still much lower than using less reliable forms of contraception, so these are a reasonable choice. 

If you know that you may want to try to conceive again within a year or so, then a form of contraception that is easy to start and stop is probably best, so this includes condoms, pills, the ring or patch.

Anyone who suffers an ectopic pregnancy is advised to avoid becoming pregnant for at least two proper menstrual (period) cycles after their treatment, which is normally about three months. This allows there to be a clear LMP (Last Menstrual Period/conception) date, to date a new pregnancy from. It also allows the internal inflammation and bruising to heal and for the necessary process of grief to surface and be worked through.

This ‘wait’ is essential if you have been treated with methotrexate because the drug may have reduced the level of folate in your body, which is needed to ensure a baby develops healthily. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as cleft lip, cleft palate, or even spina bifida or other neural tube defects. Even though the drug is metabolised quickly, it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given.

Methotrexate can also affect the way your liver works and so you need to give your body time to recover properly and to have taken folic acid supplements before a new pregnancy is considered. The current advice is to take folic acid for at least 12 weeks before you conceive but you must not begin to take folic acid supplements until the hCG levels have fallen to below 5<mIU/mL.

If you are still waiting for your first period but decide to have intercourse, then the suggested method of preventing pregnancy is one of the barrier methods (cap, condom, diaphragm or femidom). Introducing a synthetic hormone in the form of a contraceptive pill before this prevents the body from ovulating and establishing a normal pattern.