Ectopic Pregnancy, Explained

Whether you are conceiving naturally or via fertility treatment there’s always a risk that and ectopic pregnancy may occur. This is often when two common misconceptions come in:

  1. If you’re doing IVF this shouldn’t happen, because you’re placing the embryo where it should be.
  2. There’s a higher risk of ectopic pregnancy with IVF.

Ectopic Pregnancy? Say What?

An ectopic pregnancy is when an embryo implants and pregnancy occurs/grows anywhere outside of the uterus. The most common type of ectopic pregnancy is within the fallopian tube, which is often referred to as a tubal pregnancy. Ectopic pregnancies can also occur in the cervix, within a C-section scar, in muscle tissue or even outside of the reproductive organs.

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Regardless of the method of conception, there is no way to actually stick an embryo into the uterine lining – that’s something that occurs on its own. That being said, if the embryo is released outside of the uterus during an embryo transfer when doing IVF, then, of course, the risk is higher. But this is rarely the case with experienced reproductive endocrinologists.

Because getting pregnant wasn’t hard enough, the little embryos like to occasionally go rogue on us to boot!!

Why Do Ectopic Pregnancies Occur?

Because getting pregnant wasn’t hard enough, the little embryos like to occasionally go rogue on us! There are certain conditions and medical histories that increase the likelihood of ectopic pregnancy. And unfortunately, the risk of having another ectopic pregnancy increases once you have had one. This is due to the scar tissue that can be left behind. Prior to trying to conceive again, there is testing that can be done to ensure that all is clear. This is the HSG exam and it allows your doctor to see the condition of your uterine cavity and fallopian tubes.

You can absolutely have a successful pregnancy after having an ectopic. It just means your doctor may need to do a little more legwork prior to attempting again. It’s just another hurdle, as awful as it can be, but TTCers are strong, willing and able to conquer all the obstacles!

Below is a list of medical conditions that can increase your likelihood of having an ectopic pregnancy.

  • Pelvic inflammatory disease (PID)
  • Previous trauma or surgery in the pelvic/abdominal area
  • A D&C Procedure
  • Congenital defects
  • Conceiving after having your tubes tied or while an IUD is in place (…OOPS!)
  • Smoking
  • Endometriosis

Look out for this.

Often times there are no early signs of an ectopic pregnancy. The common stage of feeling anything is around 6 weeks of pregnancy, which can be too late as there are cases where it becomes more serious earlier than that. Many OB/GYNs won’t see their patients until at least 6 weeks of pregnancy. So, it’s very important to observe for any one-sided pelvic pain – sharp or dull or alternating between the two – vaginal bleeding, faintness, dizziness, nausea and/or vomiting. If anything feels off to you call your doctor. Always advocate for yourself and don’t feel bad about it!

Ectopic Pregnancy Treatment and Then What?

They key is to catch and treat an ectopic pregnancy as early as possible, prior to possible bleeding and/or rupture. The most common line of early treatment is methotrexate. Methotrexate is technically a chemotherapy agent that is given via injection.

The chemotherapy part can sound very scary, I know, but when you break it down it becomes less so. Chemotherapy drugs like methotrexate work by attacking a rapidly dividing cell. And, an embryo is a cluster of rapidly dividing cells. In this case, our little cluster decided to be a rebel! The only caveat here is that you can’t try to conceive for 3 months after the last dose and there are typically 2 doses.

A lot of my patients and clients become frustrated with the wait time after methotrexate. I can’t blame them. The thought of a 3-month wait can feel unbearable when you’ve waited so long to get pregnant and then are rocked with an ectopic pregnancy diagnosis. But rest assured, that is the best line of treatment for ectopic pregnancy and it puts your safety as the top priority.


The information provided above is for informational purposes only and should not be construed as medical advice or a substitute for medical care.

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