Recurrent miscarriage and recurrent ectopic?

[loeylo]

Has anyone else had more than one ectopic and recurrent miscarriages?

I had two mmc, an ectopic (right tube, methotrexate) dd (5yo, healthy and happy!) a chemical pregnancy at 5w and I’ve just found out I’m having another ectopic on my other tube, and probably going to have methotrexate.

They are saying there is nothing that can be done to help me which absolutely sucks. No tests, no follow ups beyond checking the ectopic resolves.

From what I read we have roughly 63% chance of ever having a successful pregnancy, at least 10% chance of another ectopic (probably higher as I can’t find odds of 3rd one) and 40% chance of another miscarriage. Pretty grim reading.

 

[dairymomma]

I am no expert on recurrent ectopic pregnancies but I do know that the odds of an ectopic do go up if you've had one. But I want to say it was only for that particular side-if it was a tubal pregnancy. The reasoning my doctor gave is that an ectopic pregnancy in the fallopian tube may have been caused by scar tissue or other obstructions in the tube that prevented the egg from getting into the uterus before implantation. And a tubal pregnancy, even if successfully treated with methotrexate or other non-surgical means, may cause scarring in that tube which could then cause more troubles. But I don't know if I've heard that one ectopic in one tube will increase the odds of one in the other tube.

That being said, I think the best way to approach those grim statistics is to look at the positives. There are plenty of women who have had ectopic pregnancies and gone on to have successful pregnancies afterwards. And it's important to remember that these stats are for REPORTED ectopics/miscarriages. Not all are reported if the woman either doesn't find out she's pregnant and/or doesn't know she had an ectopic pregnancy since some of them can end on their own before it's confirmed.

Your best bet is to talk to your doctor and see if there's anything they suggest looking into. It may be worthwhile to have an HSG or some sort of imaging done before you try again to make sure that your tubes are both clear and unobstructed since you've now had ectopics in both tubes. If your doctor refuses to dig deeper, then find someone who will. I've 'fired' more than one doctor who blew off my issues because I was tired of hearing 'just try again' when faced with my inexplicably numerous miscarriages and first trimester bleeding. I now have a doctor who listens to me and goes above and beyond to help me find answers. We're done trying but that doesn't mean I am done doctoring. I have several family members who have had issues with severe bleeding during periods or developed cysts/fibroids and needed surgical intervention varying from removal of the cyst to a partial hysterectomy so I am monitored closely so we can catch these issues sooner rather than later if I develop them. And I wouldn't be in this position if I'd stayed with my other doctors.

and I'm hope this latest loss is resolved without needing surgery and that you find answers if you decide to dig deeper into this.

 

[loeylo]

Thanks for your reply, I remember you from previous PAL/recurrent miscarriage threads.
The thinking was that because I had an ectopic in both tubes, they are probably “caused” by something. If it had happened in the same tube, then the cause would likely be the first ectopic.
I have no known risk factors of recurrent ectopics - pelvic inflammatory disease, endometriosis, pelvic surgery (other than my c section which was after my first ectopic) or STI’s (never had any or been in risky sexual situations, I’ve only slept with three people, my first boyfriend we were both each other’s firsts, then I had a short relationship that we always used barrier contraception, my current partner and I both got tested when we stopped using condoms and were both clear, I was also tested when pregnant with my dd and it was clear, this was after my first ectopic, I’m confident that my partner hasn’t cheated on me)
They think it might be a structural problem. The only thing that has ever flagged up is very high progesterone (it was 49 at 7dpo and 63 at 5+0) which I’ve read can cause cilia dysfunction and is a risk factor for ectopic pregnancy.
I am waiting on my gp to call me back to arrange an hsg.
I’ve since found out that I’ve got roughly 30% chance of another ectopic, since both tubes are blocked. The consultant thinks it might be for the best to have my tubes removed and go straight to IVF. We would have to self fund the IVF.
Self funding isn’t completely out of the question, but it would mean putting our house move on hold.

 

[loeylo]

Day 4 hcg - up by 1000 to 5200ish.

not good.

 

[Bevziibubble]

I'm so sorry. I hope that you get some answers soon

 

[dairymomma]

Thanks for your reply, I remember you from previous PAL/recurrent miscarriage threads.
The thinking was that because I had an ectopic in both tubes, they are probably “caused” by something. If it had happened in the same tube, then the cause would likely be the first ectopic.
I have no known risk factors of recurrent ectopics - pelvic inflammatory disease, endometriosis, pelvic surgery (other than my c section which was after my first ectopic) or STI’s (never had any or been in risky sexual situations, I’ve only slept with three people, my first boyfriend we were both each other’s firsts, then I had a short relationship that we always used barrier contraception, my current partner and I both got tested when we stopped using condoms and were both clear, I was also tested when pregnant with my dd and it was clear, this was after my first ectopic, I’m confident that my partner hasn’t cheated on me)
They think it might be a structural problem. The only thing that has ever flagged up is very high progesterone (it was 49 at 7dpo and 63 at 5+0) which I’ve read can cause cilia dysfunction and is a risk factor for ectopic pregnancy.
I am waiting on my gp to call me back to arrange an hsg.
I’ve since found out that I’ve got roughly 30% chance of another ectopic, since both tubes are blocked. The consultant thinks it might be for the best to have my tubes removed and go straight to IVF. We would have to self fund the IVF.
Self funding isn’t completely out of the question, but it would mean putting our house move on hold.

I would push for the HSG and see if that shows anything. It doesn't hurt to make sure there's nothing going on because you can have scar tissue or debris or even fluid in your tubes and not know it. All can contribute to ectopic pregnancies even if you don't have risk factors for it. I have an aunt who had no known risk factors for scar tissue to form but her tubes were so scarred shut, her doctor couldn't believe she had kids naturally. (She had moved to a new city a few years before this and was seeing him for worsening period bleeds. She ended up needing a partial hysterectomy and the doctor wanted to tie her tubes before the surgery. When he went in to place the Essure springs, he couldn't believe it because the scar tissue was so bad, he could barely get the springs placed.)

Good luck and I hope the ectopic resolves itself soon so you can avoid surgery and get things figured out. Recurrent miscarriage is hard but it sounds like you at least have a tentative game plan.