How can an egg travel down 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 point of ovulation, are sent a chemical signal 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 place, i.e. 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 end of the Fallopian tube begin to move gently drawing the egg toward the end of the Fallopian tube (like lots of little fingers waving and drawing the egg towards it).

Can my Home Pregnancy Test (HPT) tell me if I am ovulating and can my Ovulation Predictor Kit (OPK) tell me if I am pregnant?

It is possible for an OPK to detect pregnancy, although this is not always reliable. It is not, however, possible to use an HPT to detect ovulation. The DNA that makes up the strands for hCG, which is the hormone associated with pregnancy, is only one strand different 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 extra molecular twist.

Can a menstrual cycle tracking app help while trying to conceive?

Yes. A study looked at various apps that are used to track the menstrual cycle and analysed whether they helped influence chances of conception. The study showed that the use of such apps was associated with increased chances of conception ranging from 12% to 20% per cycle of attempt.

Does drinking alcohol affect fertility?

Yes, alcohol affects fertility by disrupting the delicate balance of the menstrual cycle. Clinical research data suggests that women, who drank socially, 1-5 drinks per week, were at a greater risk of decreased fertility when compared to women who remained abstinent.

Does smoking affect fertility?

Yes, evidence shows that smoking impacts both male and female fertility. Breathing in someone else's cigarette smoke (passive smoking) is also likely to reduce the chances of getting pregnant.

Is there anything I can do to guarantee my chances of conception next time?

Unfortunately, nothing can guarantee a pregnancy, but if you have a history of abdominal pain which continues after the ectopic pregnancy, you should see your doctor/GP to make sure you do not have a persistent infection that might impact future fertility. Having regular sexual intercourse is a good way to approach future conception.

I have read about alternative therapies and supplements for fertility - do these work?

While we understand that many people are interested in the use of alternative and complementary therapies, we do not endorse these on our site. Many complementary medicines are powerful and can have harmful side effects if misused. They may also interact with medicines that you may already be taking or intend to take. Please remember that “natural” does not always mean safe – indeed some of the medicines that are prescribed today (including some controlled drugs) are derived from natural products.

What tests, treatments, or investigations can be carried out to ensure an ectopic pregnancy will not happen again?

Sadly, there are no tests or investigations that can be done to assure you that you will not experience an ectopic pregnancy again.

I have been referred for a tubal patency test. What is it?

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 state of not 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 up on the x-ray. They then watch to see if the dye moves freely through the uterus and Fallopian tubes to look for a block that may be causing fertility problems.

What are the limitations with a tubal patency test?

Even if a tubal patency test shows an open Fallopian tube, it does not show whether it will work – only a normally located pregnancy can show that at least one Fallopian tube worked.

My doctor says I do not need to have a tubal patency test. Why?

Doctors prefer not to use a tubal patency test unless they really need to because it is not a 100% accurate test. Furthermore, it is an invasive test and there is a small (1%) chance that it can cause infection of the Fallopian tubes hence their preference to only perform the test when it is unquestionably required.

What is selective salpingography?

Selective salpingography is when a tubal patency test, a small diameter flexible catheter is threaded inside the catheter and, with the help of the x-ray machine, can be directed right into the opening of the Fallopian tube. Once this is done, dye can be introduced directly into the Fallopian tube. With this technique, it is possible to demonstrate a normal, patent Fallopian tube whose opening may be in spasm. Fallopian tubes with an obstruction can also be opened by the higher pressures which can be achieved with selective salpingography.

Clomiphene or Clomid is an extremely powerful, oral (taken by mouth), medication that is often prescribed to help those trying to get pregnant if their menstrual (period) cycle is so irregular that they cannot be sure when or if they are ovulating. The medication works by blocking estrogen receptors in the brain, stimulating them to release Follicle Stimulating Hormone (FSH), and Luteinizing Hormone (LH).

Am I able to get pregnant with no Fallopian tubes?

If your Fallopian tubes were removed or both have been deemed completely blocked, it is still possible to get pregnant with IVF because it bypasses the Fallopian tube and the embryos are placed directly into the uterus.

What are the NHS criteria for being eligible for IVF?

The provision of IVF treatment varies across the country and often depends on local policies, and priority is often given to couples who do not already have children. According to the NHS guidelines, women aged under 40 should be offered three cycles of IVF treatment on the NHS if they have been trying to get pregnant through regular unprotected intercourse for two years. For women aged 40 to 42, the guidelines also say women should be offered one cycle 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 pregnant after 12 cycles of artificial insemination; They have never had IVF treatment before; They show no evidence of a shortage of eggs and they have been informed of the additional implications of IVF and pregnancy at this age.

I feel pregnant but my home pregnancy test is negative. Why is this?

There can be a number of reasons for feeling pregnant while still having a negative pregnancy test. Progesterone in the body can sometimes be interpreted as the feelings you might get in early pregnancy and can leave you feeling disappointed when a period arrives a few days late. If you ovulate later in the cycle, the egg may not have implanted for as long as necessary to produce the hCG hormone which is what a home pregnancy test detects. The egg may not have implanted for as long as necessary to produce the hCG hormone which is what a home pregnancy test detects. The test may be from a faulty batch.

My home pregnancy test was negative to begin with but now seems to be positive. What should I do?

To get an accurate result, it is essential you follow the instructions on the Home Pregnancy Test pack. You should preferably test with the first urine of the day and in urine which has been in your bladder for at least four hours, and don't trust a result that appears after more than 10 minutes.

My home pregnancy test is positive but my doctors test is negative. Why is this?

There is the possibility that the test the doctor is using is not as sensitive as your home pregnancy test, or if you ovulate later in the cycle, the egg may not have implanted for as long as necessary to produce the hCG hormone which is what a pregnancy test detects or the test may be from a faulty batch.

Trying to Conceive Again

Medically Reviewed by:Jackie Ross BSc MB.BS MRCOG& Professor Andrew Horne MB ChB PhD FRCOG FRCP& Professor Colin Duncan BSC(hons), MBChB(hons), MD, FRCOG

Last Reviewed:01/06/2021

Next review date:01/06/2024

Written by: The Ectopic Pregnancy Trust

This is an emotional time and some people are desperate to try to conceive again after an ectopic pregnancy whereas others are frightened and feel they need more time to recover emotionally and physically. Everyone grieves differently and there is no right or wrong decision when choosing to wait or try again quickly for another baby.

Explaining Ectopic Pregnancy: Trying to conceive again (with subtitles)

Support the work that we do by donating to The Ectopic Pregnancy Trust

We don't charge for any of our services or information on this website. You can donate to support the much-needed resources that we provide for anyone affected by ectopic pregnany. We sincerely thank you for any donation that you are able to make.

Answering your questions on conceiving after an ectopic pregnancy
It is likely you have been advised to wait for three months if you have had methotrexate, or for two full menstrual cycles (periods) after surgery or expectant management, before trying to conceive. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is not your first period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy.

Statistically, the chances of having a future successful pregnancy are very good and 65% of women are healthily pregnant within 18 months of an ectopic pregnancy. Some studies suggest this figure rises to around 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(s), age, your general and reproductive health and how often you have sex.

Detailed general information can be found here on our website. Please remember that online medical information is no substitute for expert medical care from your own healthcare team.

Below is a list of common questions that we are asked about trying to conceive. This page covers questions on timing, ovulation, lifestyle, testing, assisted conception, and pregnancy tests.

Time related questions

Why must I wait for three months before trying to conceive?

While there is no clear, researched evidence on how long a couple should wait to try to conceive after having treatment for ectopic pregnancy, we and other medical professionals advise that it may be best to wait for at least three months or two full menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is not your first period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy.

Physically, this timeframe is to allow your cycle to return to normal and for there to be a clear period to date a new pregnancy from. The date of the first day 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 you have after an ectopic pregnancy may be heavier than usual and the second more like your usual period. A normal period would suggest you are hormonally ready to be able to try to conceive. Having two periods can also give an idea of menstrual cycle length, which may be different for a few months after your ectopic before settling back into its usual rhythm.

This wait allows the internal inflammation and bruising from the ectopic and any associated treatment to heal.

In addition to the physical aspects of ectopic pregnancy, many people also feel an intense emotional impact. Taking time before trying to conceive again enables the necessary process of grief to surface and be worked through. The emotional recovery that is often needed can be significant and many underestimate this aspect.

If you have had either one or two injections of methotrexate, you 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 acid supplement for 12 weeks before you try to conceive.

This is because the drug may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The methotrexate is metabolised quickly but 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. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as cleft lip and palate, or even spina bifida or other neural tube defects.

If you have had medical management followed by surgery, you can start taking a folic acid supplement again once your doctors have confirmed that all of the pregnancy has resolved. This is particularly important if you have been having blood tests to check hCG levels after your surgery. You can start to try to conceive again 12 weeks after the date that the methotrexate was administered.

The NHS website has more information on vitamins, supplements, and nutrition during pregnancy.

Ovaluation related questions

When will I ovulate again?

Before your first period arrives, you will ovulate. The period when it returns will indicate that you are ovulating again. It is possible to ovulate 14 days after surgical treatment and during methotrexate treatment, so it is important to be aware that it is possible to become pregnant without having a period first, if you are not using some form of contraception.

Have I only got half of my fertility?

When a person has only one Fallopian tube, they are still able to get pregnant from an egg released by the opposite ovary as an egg from one ovary can travel down the Fallopian tube on the other side. Approximately one-third of pregnancies are a result of pick-up 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, it is not a ‘wasted’ cycle.

What do ovulation kits predict?

An ovulation predictor kit measures Luteinising Hormone (LH). A surge in LH leads to ovulation within the next 12 hours. The egg does not always get released from the ovary in spite of a surge but it is a very good marker. A positive pregnancy test around 14 days after you think 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 suggest that ovulation is about to occur within 24–48 hours, giving two days to engage in sexual intercourse or artificial insemination with the intention of conceiving.

As sperm can stay viable in the female reproductive system for several days, LH tests are not recommended for contraception, as the LH surge typically occurs after the beginning of the fertile window.

Is it true that I ovulate on alternate sides each month?

We naturally assume that we will ovulate from alternative ovaries each month (left ovary, right ovary, left, right etc.) This is not true and varies. Some will ovulate from the same side each month with an occasional ovulation from the other side, while others will 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 one gives up (but not always – sometimes ovulation occurs from both ovaries in one cycle or twice from one ovary – this explains how we get non-identical twins naturally). It depends on which ovary contains the egg that is at the right stage of development at the point in time at the time of ovulation and is nothing to do with a set pattern.

The side we ovulate from does not strictly matter as an egg from one ovary can travel down the Fallopian tube on the other side.

How can I tell if I am ovulating?

The menstrual cycle lasts about 28 days for most and ovulation usually happens 10 to 16 days before the start of your next period. When you’re ovulating, you are at your most fertile so it is the best time 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 clear, stretchy and slippery (like egg-white consistency) when you ovulate.