Ectopic pregnancy and my fertility

Things escalated quickly.

The test strip was faintly positive, and I realised that last month’s light period may have been implantation bleeding. I dared to believe that I was ever-so-slightly pregnant, and the cramps were a natural part of the process. I curled up in a ball, and hoped.

The pain worsened overnight, but by morning I was vomiting, ashen-faced and my belly had swollen beyond recognition. Having fainted a few times, I finally knocked myself out on a stone floor before the ambulance arrived. Six hours, nearly five litres of blood and one lost fallopian tube later, I awoke to the news that I’d suffered a ruptured ectopic pregnancy. The surgeons performed an emergency salpingectomy: stemming the massive internal bleeding before removing the embryo and mangled tube in which it was lodged. I was in circulatory shock and my heart rate was erratic, but more importantly my baby was gone.

The lead consultant attempted to comfort me before a roomful of med students. “An ectopic pregnancy - anything outside the uterus - simply isn’t viable”. Curiously enough, this didn’t help. I pleaded whether the baby could somehow be moved. I knew this was nonsense, but I was desperate.

Ten days went by in hospital. A kindly nurse from another ward dutifully visited the ICU after her shift. She stroked my hair and showed me the neatly-healed scar from her own op, and I sobbed endlessly in return. I can’t picture her face due to the blur of drugs and trauma but sometimes I wonder if she was just a machination of my mind, like evolutionary self-preservation at its loveliest.

After the howling, despair, and devastation - who knows how long for - I briefly resented the baby. After all, it must’ve been silly to set up camp where it did, because two inches to the right and I’d have a six-year old by now. Moreover I was awash with grief and had months of recovery ahead. Amid the infections, muscular atrophy and brain fog, everything felt exhausting.

And then came the bombshell about trying for another baby, as the stats weren’t encouraging. Having had one ectopic, I had increased chance of another plus I was fast approaching my ‘scary age’ in fertility terms, which added further risk. And I had so many questions. In the absence of a lefthand fallopian tube to transport an egg happily along its way, what did that mean for my fertility? Would I only ovulate every other month when the neighbouring, serviceable ovary on the right was in business? Did that effectively halve my chances? (More on this here).

A natural, care-free pregnancy looked unlikely given it had taken nearly three years to reach this point, so I hotly pursued assisted conception. Tests and scans uncovered more gynaecological woes, but this in turn fuelled my treatment plan. The consultant recommended an IVF procedure that sidestepped the fallopian tube/s, reducing exposure to the scar tissue where another rogue embryo could implant. There was certainly risk but it felt more controlled, so I underwent fresh and frozen ICSI cycles until one morning the blue lines were back on the test strip.

I’d been here before - more times than I chose to remember - so I simply followed the process, without any expectation I’d actually meet the child I’d longed for. I sought counselling and meditated obsessively to cope with the prospect of another loss and/or cheating death a second time. Blood tests confirmed the news, and any disconcerting twinges were met with hyper vigilance as I awaited an early scan to locate the pregnancy. To my astonishment, the little embryo was precisely where it was meant to be, nestled in the lining of my uterus. Eight months later, I welcomed an early but overwhelmingly adored baby daughter, and I could not be more thankful.

What I’ve learned

Trying again

It’s advisable to wait at least a few cycles after an ectopic before trying again. In medical terms, it allows the body to return to some sense of equilibrium after chemical intervention and surgery. In emotional terms, it can take longer to heal and may not be a linear process. For me, it took a year to not only feel ‘well’ again, but to come to terms with what had happened and my fears of what may lie ahead.

Book an early scan

If you get pregnant and exhibit risk factors or experience ectopic symptoms (which can appear rapidly), an early ultrasound is vital. Badger your healthcare provider if need be.

Know your body, and be kind to it

Long after my ruptured ectopic and an emergency c-section, I experience tugging and swelling from surgical adhesions and stitches. It’s noticeably worse at certain times in my cycle, so tracking ovulation pinpoints when the pelvic inflammation will be most uncomfortable. This in turn lets me take steps to manage the pain which is a huge blessing, as I’d be crabby, short-tempered and sore without it.

For more information and support, visit the Ectopic Pregnancy Trust.

The facts

• An estimated 1 in 80 pregnancies in the UK are ectopic.
• A fertilised egg implants outside the uterus (most commonly in the fallopian tubes), but is unable to develop into a healthy baby.
• Ectopic pregnancies can go undetected and may require no medical treatment in the early stages, but symptoms typically develop within the fourth and twelfth week and can be fatal if left untreated.
• Treatments include expectant management, chemical intervention with the drug methotrexate or surgery.
• Around 85% of women get healthily pregnant within two years of an ectopic pregnancy.
• Almost a third of women under 35 go on to have a baby via assisted conception following an ectopic pregnancy.