Failed Expectant management - confused!

[cable]

Hi there,

I've been reading through a lot of posts (and Googling way too much) but I'm not sure if my situation has been experienced by anyone else!

I fell pregnant my first time trying in September - my husband and I were over the moon as we had been waiting for a year because of other medical reasons. Fast forward to October - I had had 2 days of left sided cramping and back pain at 6 weeks then dark discharge so went to EPU for a scan on 26th. They found a small pregnancy in my left tube and bHCG and progesterone were low so they were pretty confident I could be managed expectantly. I started bleeding the following day - quite heavy and then much more painful on day 3 with a lot of cramping and left sided pain, thought this was all encouraging that the pregnancy was resolving on its own without treatment. Repeat bloods on day 3 of bleeding that week showed slowly falling hormones so the team were confident that it would self-resolve.

The following week my bHCG started to double every two days and I ended up having emergency surgery with 100mls of blood in my pelvis and removal of my left tube on 4th November, they also found I have endometriosis but it seems to be mild. I didn't have any bleeding after surgery as I had already shed the pregnancy lining of my uterus the week before.

I'm feeling devastated and so hopeless that this will either happen again or maybe never happen for us and we want to start trying again as soon as our 3 months' wait is up.

The issue is I'm a bit confused about when to expect my period so that we can start counting cycles - I know that it can take up to 12 weeks but do I count this from the surgery or from after I bled?

Has anyone else been told they have endometriosis when they had their surgery? Were you able to have a successful pregnancy after all this despite surgery + endometriosis?

Thank you for all your help

[EPT Host 20]

Dear cable,
I am so sorry to hear of your ectopic pregnancy and loss,
It is normal to feel anxious about the future. We experience a mix of emotions from wanting to try again to being petrified of what may lie ahead. We never forget but we can learn to accept what happened. It is a slow process that might be weeks or months ahead. In time, we can get to a place where we feel comfortable trying again. When this is, is individual for each person. There is no timeframe for recovery, take each day as it comes.
Importantly early scans avail. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.

The chances of a further ectopic after a first in UK is 10%. So that's 90% chance of the embryo being in right place next time.
While generally it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years.

As a gentle reminder regarding conceiving again, we and many medical professionals advise waiting for two menstrual cycles. It is important to allow time for your body to recover and emotions to surface and be worked through. This is so that you have some comfort that your body is returning to its natural rhythm and you have a last menstrual period date from which to date a new pregnancy - key information in checking you are not suffering from an ectopic pregnancy in the future. The first bleed soon after surgery for ectopic pregnancy is not classed as a period as it is the body's response to falling hormone levels. As you have had this, I would recommend to wait until you have had 2 more periods.

Unfortunately I am not medically trained so cannot give you specific advice on the finding of endometriosis, and I would advise speaking to your GP with any concerns. Importantly, help is available if conceiving naturally has not been successful after some time trying - and the EPT advises that women under 35 should seek medical advice following 12 months trying to conceive and those over 35 should seek advice after 6 months.

Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
**************************************************************************
During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.
If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?
Further information is available at ectopic.org.uk
Email us: ept@ectopic.org.uk
We provide a call-back helpline service: 020 7733 2653
Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
***************************************************************************