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  #1  
August 2nd, 2008, 10:29 AM
pattyandthemoos's Avatar Administrator
Join Date: Feb 2004
Location: Michigan
Posts: 61,614
I hope you girls don't mind me dropping in. I am starting to get concerned that I am not going to get pregnant on my own. A little history. I have had two miscarriages and two ectopic pregnancies. My last ectopic was in November and I lost my right tube. I have not gotten pregnant again since then. We started trying right after the ectopic tried for five months and then took three months off due to insurance issues. We did not try/not prevent during the month of June and also this month. I am not charting or anything at the moment but the last couple months we have also not been preventing. I am not sure how much longer I should try before talking to the doc about other options.

When I had my ectopic the doc told me if I didn't get pregnant in six months to come back and talk to him and we could discuss IVF. I don't know if I am just being impatient or if I really am going to keep having problems getting pregnant since I have only one functional tube. I am going to be 35 next week and I know your fertility starts to decrease as you get older. For girls that have had IVF how long did you wait?

Also is there anyone on the board that has had issues with fertility after an ectopic? Did your doctor give you any other options besides IVF? Also I have read that your chances of having an ectopic increase with IVF so that concerns me? Has anyone had IVF after an ectopic? What did your doc tell you about your risks, etc?

Any input would be appreciated.
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  #2  
August 2nd, 2008, 01:08 PM
greenchild's Avatar Platinum Supermommy
Join Date: Jul 2006
Location: MN
Posts: 15,839
queen of ectopics here. actually all 3 of my failed pg's were heterotopic, meaning one in the right place and one in the wrong place.

my history so you know where I'm coming from:

first off, I've never had any infections or STD's or any of the typical things that cause scar tissue (which is a big cause of ectopics). so mine are all ?????

1st pg, thought it was only ectopic, dr's let me bleed internally for 3 weeks before agreeing it was ectopic. found out at the post op appt there was one inutero too but it had died. Lost my left tube. Dr said if I didn't get pg in 6 months of actively trying, to come in.

2nd pg (5 months later), thought I had a m/c at about 6 weeks, I still strongly feel this way, I know what I passed, and there was a lot of cramping/bleeding that came with it. Went in for a followup appt and found out I was still pg. Dr refused to do an u/s to confirm anything, no matter how many times I asked over the next few weeks. He just wanted me to take methotrexate and refused to do anything else. I lost my right tube, it ruptured about 9w.

so on to IVF. really ticked me off, the left tube could have been salvaged but that dr said my right tube was "perfect" and why bother with trying to save a damaged tube. gee, it was perfect, huh . . .

3rd pg, transferred 2 embies, now *I* know I have what one dr called a "tiny" uterus, but the RE wasn't concerned about the size and did the usual placement of the embryos inutero. I was told having an ectopic pregnancy with IVF is about a 1% chance. Had my first u/s to see viablilty and baby count at 6w5d. They saw ONE baby, measuring a week behind and did not check thoroughly for another, even though they knew my history. My uterus ruptured the next day (unbeknownst to me) and I was in the ER 3 days later with shoulder pain. 7 hours into the ER visit they found the 2nd large, healthy baby. It had implanted into the tiny opening of my right tube. Even though the tube was gone/sealed off, there is still an opening in the uterus to it. Since the opening of the tube is a BAD place to implant (corneal ectopic), it ruptured. They took that baby out and sewed me up. I miscarried the other (a b/o) about 8 weeks later.



okay, now that long story's over with . . .

it's typical for women to alternate ovaries each cycle (mine do). Not everyone does though, that could be part of your problem, if your right ovary is more active than your left. It's unlikely, but not impossible to get pg with the active ovary on the opposite side of the functioning tube.

seeing your history, I'd start with the basic blood tests if you haven't had them done. FSH levels are supposed to give you and idea of your ovarian reserve, as in do you have lots of eggs left. Then I'd have them do an HSG to determine whether or not your left tube is open or has any other problems. Sometimes the problems are fixable, and many times women get pg right after having a HSG as it kind of cleans the tube(s) out.

If your FSH is good and your tube is clear, do the charting/temping/opk's stuff and give it a go. But considering your age your dr may or may not recommend fertility drugs to give you a boost.

If your FSH isn't great and your tube is clear, they will probably start you on fertility meds to give you a better chance of conceiving with either better quality eggs or more of them, depends on what meds they give you.

If your FSH isn't great and your tube is blocked, your option is IVF. They do have different protocols to use when your FSH isn't great. Mine was borderline bad and we got 6 eggs, all 6 fertilized, and 5 made it to grade 1 embies. All were 7 or 8 cell, which is really great. however, just bc they look great at that stage doesn't necessarily mean they will survive. 1 of mine was the blighted ovum, and 2 didn't make it thru the thawing process for the FET (well, 1 died and the other lost 1/2 its cells). So out of 5, only 1 implanted in the right place and is surviving.

Seeing as what happened to me with the first round of IVF, the RE did a lower placement of the embryos this time (FET) and that was what I really needed.

I'd say if you have a normal sized uterus the placement of the embies shouldn't be an issue.

another thing to get checked is have your SO get a semen analysis. If his boys are a problem, alot of the time men can take certain vitamins or even fertility meds to give their boys a boost. They can do IUI's, where they wash the sperm and put them in you. Or, if you do go with IVF, there is a procedure (which costs extra) but they inject the sperm directly into the egg.

Keep in mind your chances with IVF start to go down after age 35, but I think alot of that "chance" depends on your blood test results.


My best advice, though, is since you have had an ectopic, no matter HOW you get pg the next time (IVF or natural) make SURE they check you thoroughly. don't let them just do a quick scan, make sure they check the entirety of your reproductive system and your abdomen. Ideally, they should do a transvaginal AND a abdominal u/s. They haven't found ectopics this time for me, and I made them check thoroughly, but it still doesn't take away my fear.

I hope that helps, if you have any more questions for me I'm happy to answer.
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  #3  
August 3rd, 2008, 06:19 AM
pattyandthemoos's Avatar Administrator
Join Date: Feb 2004
Location: Michigan
Posts: 61,614
Quote:
queen of ectopics here. actually all 3 of my failed pg's were heterotopic, meaning one in the right place and one in the wrong place.

my history so you know where I'm coming from:

first off, I've never had any infections or STD's or any of the typical things that cause scar tissue (which is a big cause of ectopics). so mine are all ?????

1st pg, thought it was only ectopic, dr's let me bleed internally for 3 weeks before agreeing it was ectopic. found out at the post op appt there was one inutero too but it had died. Lost my left tube. Dr said if I didn't get pg in 6 months of actively trying, to come in.

2nd pg (5 months later), thought I had a m/c at about 6 weeks, I still strongly feel this way, I know what I passed, and there was a lot of cramping/bleeding that came with it. Went in for a followup appt and found out I was still pg. Dr refused to do an u/s to confirm anything, no matter how many times I asked over the next few weeks. He just wanted me to take methotrexate and refused to do anything else. I lost my right tube, it ruptured about 9w.

so on to IVF. really ticked me off, the left tube could have been salvaged but that dr said my right tube was "perfect" and why bother with trying to save a damaged tube. gee, it was perfect, huh . . .

3rd pg, transferred 2 embies, now *I* know I have what one dr called a "tiny" uterus, but the RE wasn't concerned about the size and did the usual placement of the embryos inutero. I was told having an ectopic pregnancy with IVF is about a 1% chance. Had my first u/s to see viablilty and baby count at 6w5d. They saw ONE baby, measuring a week behind and did not check thoroughly for another, even though they knew my history. My uterus ruptured the next day (unbeknownst to me) and I was in the ER 3 days later with shoulder pain. 7 hours into the ER visit they found the 2nd large, healthy baby. It had implanted into the tiny opening of my right tube. Even though the tube was gone/sealed off, there is still an opening in the uterus to it. Since the opening of the tube is a BAD place to implant (corneal ectopic), it ruptured. They took that baby out and sewed me up. I miscarried the other (a b/o) about 8 weeks later.



okay, now that long story's over with . . .

it's typical for women to alternate ovaries each cycle (mine do). Not everyone does though, that could be part of your problem, if your right ovary is more active than your left. It's unlikely, but not impossible to get pg with the active ovary on the opposite side of the functioning tube.

seeing your history, I'd start with the basic blood tests if you haven't had them done. FSH levels are supposed to give you and idea of your ovarian reserve, as in do you have lots of eggs left. Then I'd have them do an HSG to determine whether or not your left tube is open or has any other problems. Sometimes the problems are fixable, and many times women get pg right after having a HSG as it kind of cleans the tube(s) out.

If your FSH is good and your tube is clear, do the charting/temping/opk's stuff and give it a go. But considering your age your dr may or may not recommend fertility drugs to give you a boost.

If your FSH isn't great and your tube is clear, they will probably start you on fertility meds to give you a better chance of conceiving with either better quality eggs or more of them, depends on what meds they give you.

If your FSH isn't great and your tube is blocked, your option is IVF. They do have different protocols to use when your FSH isn't great. Mine was borderline bad and we got 6 eggs, all 6 fertilized, and 5 made it to grade 1 embies. All were 7 or 8 cell, which is really great. however, just bc they look great at that stage doesn't necessarily mean they will survive. 1 of mine was the blighted ovum, and 2 didn't make it thru the thawing process for the FET (well, 1 died and the other lost 1/2 its cells). So out of 5, only 1 implanted in the right place and is surviving.

Seeing as what happened to me with the first round of IVF, the RE did a lower placement of the embryos this time (FET) and that was what I really needed.

I'd say if you have a normal sized uterus the placement of the embies shouldn't be an issue.

another thing to get checked is have your SO get a semen analysis. If his boys are a problem, alot of the time men can take certain vitamins or even fertility meds to give their boys a boost. They can do IUI's, where they wash the sperm and put them in you. Or, if you do go with IVF, there is a procedure (which costs extra) but they inject the sperm directly into the egg.

Keep in mind your chances with IVF start to go down after age 35, but I think alot of that "chance" depends on your blood test results.


My best advice, though, is since you have had an ectopic, no matter HOW you get pg the next time (IVF or natural) make SURE they check you thoroughly. don't let them just do a quick scan, make sure they check the entirety of your reproductive system and your abdomen. Ideally, they should do a transvaginal AND a abdominal u/s. They haven't found ectopics this time for me, and I made them check thoroughly, but it still doesn't take away my fear.

I hope that helps, if you have any more questions for me I'm happy to answer. [/b]
Wow! You have had quite an experience. My last ectopic was heterotopic as well. That is why they missed it. They did the ultrasound and saw the sac in my uterus and I think they didn't look close enought at my tubes even with my history. My tube ended up rupturing a few days after they did the ultrasound.

The thing is I have had an HSG done before. I had it done after my three losses and before I had my first son (I had two miscarriages and one ectopic at this point). Everything was clear. That was one of the reasons I was so shocked when my last pregnancy was ectopic.

I am not sure that I need to have an FSH test done. I have four kids and did not have any problems getting pregnant up until I lost my tube. I am very paranoid about having another ectopic. I am not sure what your experience was like but I lost a lot of blood and it was the most awful experience of my life. I felt terrible and I thought I was going to end up needing a transfusion I was so weak and my blood pressure was so low. I don't want to go through that ever again. Now that you have mentioned that you had a third ectopic after IVF it makes me very very paranoid.

I am probably going to wait at least a couple more months and then if I don't get pregnant I am going to go see the doc and see what my options are. Thank you so much for sharing your experience.
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  #4  
August 3rd, 2008, 07:07 AM
Platinum Supermommy
Join Date: Nov 2007
Location: USA
Posts: 7,867
If I were you Patty, I would check with your Dr. and see what he/she suggest. It doesn't mean you have to go with what they say...but when you are ready to use the resources available to you, you will already have a plan in place. At least you will have an idea of what you can expect if you don't get pregnant in the mean time.
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