Your TTC Strategy 9: Understand Pregnancy Loss

The diagnosis of an ectopic pregnancy is usually a surprise and is often emotionally traumatic. Many women are in the midst of enjoying their pregnancy when they receive the diagnosis, while some women do not even know they are pregnant and suddenly must contemplate the possibility of major surgery or medical treatment.

Delayed or abnormal menstruation can be an early sign of an ectopic pregnancy. If pregnancy is confirmed, early abnormal levels of hCG, pelvic pain, and/or irregular bleeding in the first weeks of pregnancy can indicate an ectopic pregnancy. If a woman knows or suspects that she is pregnant, and has experienced pelvic or lower abdominal pain, she should consult her physician, even if the pain decreases in severity or stops altogether. Sometimes an ectopic pregnancy is suspected when an ultrasound does not show a pregnancy inside the uterus.

With early diagnosis of an ectopic pregnancy, treatment is possible that preserves the fallopian tube.

• One option is nonsurgical treatment with methotrexate, a drug that has been used to treat cancers that are derived from placental tissue (gestational trophoblastic disease).
• The other option is laparoscopic surgery to remove the pregnancy tissue with preservation of the fallopian tube. Once the fallopian tube has ruptured, surgical treatment and removal of the fallopian tube is performed to save the life of the mother.

A commonly asked question from women who have ectopic pregnancies is whether the pregnancy can be removed from the tube and then transplanted into the uterus where it might grow normally. Unfortunately, this is not possible with our current medical knowledge.

Once a woman has had an ectopic pregnancy, she has a higher chance of having another one and should be monitored carefully by her health care provider if another pregnancy is attempted or suspected. If one of the fallopian tubes has ruptured or has been removed, ovulation will still occur as before but the chances of conceiving will be reduced to about 50 percent. If the tube has been saved, the chance of future pregnancy will rise to around 60 percent. The overall chance of a further ectopic pregnancy is between 7 and 10 percent.

(Learn more about advances in ectopic pregnancy care here.)