Preventing ectopic pregnancies

Q: Now that I’ve had two ectopic pregnancies, what are my chances of having a third? I am presently five weeks pregnant and am very worried. I do not know my parents’ health histories, as I am an adoptee.

A: Unfortunately, having an ectopic pregnancy does increase your chances of a repeat event.

If you have never had a tubal pregnancy, your chance of getting one is about 1% to 2%. If a woman has had a tubal pregnancy, her chances increase to approximately 10%; that is, when she conceives, there is about a 10% chance it will be in her tube, 90% in the uterus. The chances do go up even higher after two ectopics, but a lot depends on the circumstances of the ectopics as far as therapy is concerned.

Family history doesn’t play a significant role in the development of ectopics, so don’t worry about not knowing it. The most important issue here is early diagnosis. Using a vaginal probe ultrasound, your physicians should be able to tell if you have a good intrauterine pregnancy by six weeks after your last menstrual period. If they believe it is yet another ectopic, they might even be able to give you a medication called methotrexate that has been successfully used to medically treat ectopic pregnancies, thereby avoiding another surgical procedure.

But there is good news even for women who have lost both tubes to ectopic pregnancies. These women are excellent candidates for in vitro fertilization. I have one patient who was in that category, who now has two lovely (well, on some days she will dispute that!) kids through in vitro.

So, the odds are in your favor, and I hope you hear good news about an intrauterine pregnancy. But if not, there is no reason to give up hope.

What you have in your mind?