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  |  Women's Health  |  Reproductive Health  |  Fertility after an ectopic pregnancy
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Some surprising facts from the Colonel

Fertility after an ectopic pregnancy

by Dr Howard Lee

question
I am 32 years old and have one child. I fell pregnant for the second time, but it was a tubal pregnancy. After surgery the specialist said that my left tube was salvaged, but both tubes had ‘spider-like webs’. He told me my chance of having a successful pregnancy is 25% less in the left tube and 10% in the right fallopian tube. The ‘webs’ were caused by a previous infection after the birth of my son but I can’t remember having abdominal pain. Can I have another successful pregnancy?

answer
You are lucky that both tubes remain ? the ?ectopic-affected? one being salvaged through surgery, which is unusual. It seems, however, that both tubes have ?adhesive-type? lesions which can cause a repeat of the ectopic pregnancy ? or worse, infertility, because the egg is not allowed to come into contact with spermatozoa. Any further operations to try and clear out the fallopian tubes are likely to cause more scarring-type adhesions, and so be counter-productive. The usual cause of the 'spider-like webs' in the tubes is tubal infection (salpingitis). The infection usually travels up to the tubes from the uterus (womb) or vagina, and can be a consequence of childbirth, surgery, coil (IUD) contraception, or sexually transmitted infection. In each of these situations, there may be abdominal pain at the time of the infection, but in many cases, there are few or no symptoms at the time of the infection.

At least 1 in 12 women between the ages of 16 and 24 years has sexually transmitted infection, and it is on the increase. Up to half these infections are caused by chlamydia, and 70% of infected women have no symptoms. If untreated, infections may persist for months. The risk of infertility following a single episode of infection is hard to state. If chlamydia infection progresses to inflammation within the tubes or the pelvic organs (Pelvic Inflammatory Disease) then there?s a 17 per cent risk of becoming infertile.

The most frustrating thing for both of you is that you know that you can become pregnant by your partner –
if only your two cells meet together in the right place. Keep on trying but watch carefully for any menstrual irregularities. If you think you have conceived, you must have an early scan to make sure that the embryo is in the uterus, not the fallopian tubes.

If you don’t manage to conceive you could consider IVF treatment but you’ll need to discuss this with your GP.

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