Expectant management for ectopic pregnancy

27 May 2025 | By Helen

Our Story:  

My husband Tom and I started trying to conceive our first child in July 2022. We thought it would be an easy and straightforward experience and were expecting we might fall pregnant in a few months. Fast forward around one year to August 2023 and we still had not conceived.  

Over the course of a couple of days, I started to get sharp pain in my abdomen and some vaginal bleeding. I knew something was wrong. I was around the middle of my cycle and knew I wasn’t near the time of my period. I had not missed a period so didn’t really think it would be possible to be pregnant. However, something compelled me to take a home pregnancy test due to the pains and bleeding. It was positive.  

We were extremely confused, because I hadn’t missed a period and now had this bleeding and pain, alongside a positive pregnancy test. A gut instinct told me something wasn’t right.  

Luckily after a bit of research online I found our local early pregnancy unit. I called them straight away. They said to come in and have some HCG (the hormone produced in pregnancy) blood tests and further investigations to find out what was going on. Over the course of the next few days and lots of visits to the EPU (early pregnancy unit), they found that the HCG (the hormone produced in pregnancy) hormone level was not rising normally as expected in a viable pregnancy. They suspected something was wrong and ended up performing a transvaginal, internal, ultrasound scan.  

The scan was a confusing picture but eventually they determined there was a mass of about 1.2cm in the left Fallopian tube and an ectopic pregnancy was diagnosed. This time was traumatic and incredibly confusing. Why was this happening? What was the cause? Is this related to the fertility struggles? What is my fertility going to be like in the future? Confusion was the main emotion.  

We then moved onto how this would be managed with the early pregnancy unit. I was reasonably stable and asymptomatic by this point and with the mass being 1.2cm, was judged as being quite small. I was allowed to have “expectant” management. This meant we needed to wait and see if the ectopic pregnancy resolved itself on its own. This was a very scary time because we were told that at any point the Fallopian tube could rupture and lead to a potentially fatal situation.  

Luckily, the body resolved the ectopic pregnancy naturally, and I avoided having to have medication or surgery. The Fallopian tubes remained intact. However, the cause of the ectopic pregnancy and my future fertility were unknown.  

Fast forward to May 2025 and the time of writing this, we still have not conceived naturally and we are now on an in vitro fertilization (IVF) treatment journey to try to have our first baby.  

The sense of confusion around the ectopic in 2023 remains. Why did this happen? We had none of the known risk factors. Is it all related to the infertility? We are not sure we will ever get answers as to why it happened, but it will always be a part of our journey. 

If I could say one thing: There is light at the end of the tunnel. Sometimes we don’t know how long the tunnel is, or how long it will take to get through the tunnel. But what remains is that there will always be light at the end of that tunnel.

 

 

Thank you to our contributor for sharing her experience. If you would like to share your experience of ectopic pregnancy, please visit our guide for more information.                 

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