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Ectopic pregnancy after IVF

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maria5
Posts: 17
Joined: Sun Jun 13, 2021 5:46 pm

Ectopic pregnancy after IVF

Post by maria5 »

Hello,
I was recently diagnosed with an ectopic pregnancy following our first IVF cycle and have been given methotrexate. Can anyone explain how an ectopic can happen with IVF? E.g. is it to do with where the embryo is placed? Day of transfer? Fresh/frozen? Human error? I had no known risk factors prior to this (we did IVF ICSI as using donor sperm) and no previous pregnancies. I have got a follow-up consultation with the IVF clinic coming up and want to make sure I ask all the right questions. Is there anything specific I should be asking? Nearly 3 years TTC and this cycle was our first bit of hope and it ended like this, it is challenging.
Thank you for your help. xx

Mistyappie
Posts: 13
Joined: Fri May 14, 2021 5:16 am

Re: Ectopic pregnancy after IVF

Post by Mistyappie »

Hi Maria,

I was in the same situation as you, my first fresh IVF transfer and ended up with an ectopic pregnancy on my right tube. From what I researched and was told, IVF is actually a risk factor for ectopic pregnancy, because of all the injections we take to stimulate the follicles, apparently there might be quite a lot of fluids in the uterus, even when the embryo was transferred into uterus, sometimes the fluids might push it around. I think it is less likely to happen with frozen transfer, but I am not sure. So sorry you have to go through this.

maria5
Posts: 17
Joined: Sun Jun 13, 2021 5:46 pm

Re: Ectopic pregnancy after IVF

Post by maria5 »

Hello,
Thank you for your reply. I'm so sorry to hear this happened to you as well. It is such an emotional rollercoaster. That is very interesting to read about how IVF can be a risk itself with all the hormone injections etc. Thank you for explaining. Definitely something for me to ask about at my next appointment. xx

Anns88
Posts: 4
Joined: Thu Jul 01, 2021 9:36 am

Re: Ectopic pregnancy after IVF

Post by Anns88 »

Hi Maria,
Thank you for posting. I am in the exact same situation. My first IVF fresh transfer (my only remaining egg- 3DT) ended in an ectopic. I had the injection last week. I’m now worried about the future. I had a HSG done prior to IVF and my tube were not blocked. Have you have any follow up with the Ivf clinic as to support and advise?my clinic has said I must wait until I’ve been discharged from the EPAU.

maria5
Posts: 17
Joined: Sun Jun 13, 2021 5:46 pm

Re: Ectopic pregnancy after IVF

Post by maria5 »

Hello,
I am so very sorry to hear that you are going through this and I'm sorry for your loss. It is so tough, especially having been through IVF as well. Like you, this was our only embryo (the others didn't make it) and I had a Day 3 transfer. The thought of stimming again fills me with dread! And it is going to be hard to go into the next round feeling positive. I have got my follow up consultation at the IVF clinic at the end of the July and I have got a lot of questions. I am hoping I will be discharged from the EPU by then - my HCG is now in the low hundreds. I can post on here, if it would be helpful, if the clinic give me any indication of why this happened and advice for the next go (which won't be for a few months now unfortunately). I hope you are feeling ok on the methotrexate. Sending love xx

Snoopydraws23
Posts: 4
Joined: Wed Jun 30, 2021 8:07 pm

Re: Ectopic pregnancy after IVF

Post by Snoopydraws23 »

Hi Maria5,

I'm so sorry to hear you've had an ectopic pregnancy following your first round of IVF. I have had four cycles of IVF (one fresh and 3 frozen embryo transfers) now and unfortunately two of these have been right sided ectopic pregnancies. My first was managed with methotrexate (2017) and my second was emergency surgery to remove the tube (2020).

My clinic told me that they are not really sure why it happens but that IVF is a risk factor, also others things effecting fertility such as endometriosis can increase risk of ectopic too. During one of my reviews with the fertility clinic my consultant also said that it could be hormonal - that they think the embryo might gravitate back towards the fallopian tube to mimic where the embryo would usually be in its journey had it been conceived in a natural cycle. I'm not sure if I have explained that very well or how true it is but quite interesting to think about. Most importantly though, there is nothing you could have done differently to prevent it.

Happy to chat if you have any more questions! :)

maria5
Posts: 17
Joined: Sun Jun 13, 2021 5:46 pm

Re: Ectopic pregnancy after IVF

Post by maria5 »

Hello,
Thank you so much for your reply. I am so sorry to hear of what you have been through and that two of your cycles resulted in ectopic pregnancies. What a difficult thing to go through, I'm so sorry.
That is interesting what you said about the embryo gravitating back to where it would be on its usual journey. It's amazing what you learn doing IVF. I'm interested to see what I'll be told at my follow-up consultation. Though it seems like there are no definite answers.
Thank you for offering to chat. I'll see how I get on. xx

Anns88
Posts: 4
Joined: Thu Jul 01, 2021 9:36 am

Re: Ectopic pregnancy after IVF

Post by Anns88 »

Thank you for sharing your own experiences, I know that couldn’t of been easy. And I’m sorry your journey hasn’t been easy either.

Did your IVF clinic recommend a laparoscopy to explore the tubes? As I’ve read that no HDG test or transvaginal scan can show the scarring?

Did they say anything about the quality of the egg?!
As I’m worried my uterus rejected my
Day 3 egg.

maria5
Posts: 17
Joined: Sun Jun 13, 2021 5:46 pm

Re: Ectopic pregnancy after IVF

Post by maria5 »

Hi Anns88,

Sorry for slow reply. I had my consultation with the IVF clinic earlier this week and wanted to wait until I had had it before posting. I think the answers/advice I was given may differ slightly to what others have been told and posted on this thread but I think it's interesting to read different opinions.

In answer to your questions:

Firstly, I was told the fact it was a fresh cycle and a day 3 transfer did not increase the risk of ectopic. The embryo just sometimes moves out of place and I was unlucky.

My clinic did not recommend a laparoscopy to explore the tubes. I asked whether it would be worth having an HSG and was told that it wouldn't make a difference to my treatment plan so there wasn't much point. Instead I have been advised to book an ultrasound one month before commencing treatment to see if there is any tubal dilation/trapped fluid in the tubes, as this can prevent successful implantation. If there is, I can have the tubes clipped. I need to look into this more so I understand it a bit better. I have also been told they can use an 'embryo glue' for my next transfer if I want to pay for that.

In terms of egg quality, yes we did talk about this a lot, but not in relation to the ectopic pregnancy. I did have poor egg quality overall (I had 11 eggs retrieved but only 1 viable embryo), but this did not cause the ectopic. In fact my one embryo was top quality. For my next cycle, I am having a different protocol and taking some extra medication and supplements.

Happy to talk more. xx

Anns88
Posts: 4
Joined: Thu Jul 01, 2021 9:36 am

Re: Ectopic pregnancy after IVF

Post by Anns88 »

Thank you Maria5 for your reply.
Although the clinic may not of given you all your answers, I do think what they have said is very interesting. I unfortunately had to have emergency surgery and my right tube and pregnancy sac was removed a week ago :(
My HCG didn’t decrease by much although very low! An internal scan showed internal building and further growth.
Thankfully, my Right ovary was saved. I have my follow up with
My ivf clinic on Friday, so I shall let you know what they say. Ohh
The embryo glue sounds interesting. I wish you all the best for your next cycle. I too, hope we both get a better outcome with our eggs.

GwenllianGlyn
Posts: 2
Joined: Thu Aug 16, 2018 9:25 am

Re: Ectopic pregnancy after IVF

Post by GwenllianGlyn »

Hi there just want to share some positive news regarding IVF after ectopics.
I have one child who’s nearly five (born 2016). I conceived him without any issues and had a textbook pregnancy. Had a terrible time during labour and had to have an emergency c-section and haemorrhaged afterwards.
Fast forward to 2018 and fell pregnant again but unfortunately it was an ectopic and lost my left tube and baby at 8 weeks. My heart was broken. We decided to try again after 3 months, it took a lot longer as I was one tube down. 7 months maybe to conceive. Unfortunately again this was an ectopic (they believe it was on my c-section scar) but was caught much earlier at 5 and half weeks so was given methotrexate to terminate the pregnancy. This was June 2019. I’ve never felt so lost in all my life. It changed my as a person. I decided in September 2019 to do a HE Diploma in Counselling course as I needed a new focus. We were too scared to try again naturally. Beginning of 2020 we had a hsg on my remaining tube and everything looked fine, but I just couldn’t do it. So we decided that IVF was the only option for us although there were obvious risks. But lockdown came and we had to put it on the back burner. In September 2020 I met my counsultant for the first time which I cannot praise enough. He believed that the way forward for me was to do an egg collection first and then let my body rest for 3 months before doing a frozen cycle as this reduced the risk of an ectopic. This is what we did. My egg collection was done at the end of 2020 and I had my frozen embryo transfer in May (2021) and I’m currently 16 weeks pregnant with baby in the right place at last.
Sorry for the long winded story but I just want you to know that there is hope and with the right care and advice whilst doing IVF there is a chance. Hopefully now they will take all the actions needed to try and make sure that your next transfer is successful. My Consulant was adamant that I wasn’t to have a fresh transfer because of my past ectopics and that I should rest my body after egg collection. It felt like a lifetime but not in the grand scheme of things. It took my three years of heartache to get here and I just want to share a positive story with you which I hope will help. Lots of love and all the luck in the world, Gwen

maria5
Posts: 17
Joined: Sun Jun 13, 2021 5:46 pm

Re: Ectopic pregnancy after IVF

Post by maria5 »

Thank you GwenllianGlyn for sharing your positive IVF experience and wishing you all the best for your pregnancy. Interesting that you were told not to have a fresh transfer.

To those who had an ectopic after IVF, how long have you been told to wait before your next cycle? My clinic are happy for me to start 3 months after my HCG returned to 'non-pregnant'. I am desperate to do another round but my instincts are telling me to wait longer because I was treated with methotrexate and I know it can linger in the body. I am worried it might affect egg quality and I don't want to go through a whole round and not get any embryos.

Thank you for your help. xx

Anns88
Posts: 4
Joined: Thu Jul 01, 2021 9:36 am

Re: Ectopic pregnancy after IVF

Post by Anns88 »

Hi Maria,
I was told three periods after the methotrexate
And to take 500mg of folic acid. However, I’ve just been taking the cheap
Stuff from the pharmacy and taking up to 4 a day. The Dr who discharged me from my surgery said that would be fine, I didn’t need a prescription. I may contact my GP though.
Annoyingly, even with the injection, I still had to have surgery but the recovery time is the same. I am debating whether to go for a second cycle of IVF. My follow up consultation couldn’t give me any answers. Other than IVF would be my best option as it lowers my risk of another ectopic. But I’m at higher risk of a further one. I will need to self refer to my EPAU for early scan , bloods if I get a positive. Good luck with your ivf.

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