QuestionIN 2008 I WAS STARTING TO HAVE A LOT OF PAIN DURING INTERCOURSE FOR ABOUT A MONTH, AFTER THAT THE PAIN MOVED UP INTO MY RIGHT OVARY/TUBE AREA. I WENT TO THE EMERGENCY ROOM MULTIPLE TIMES AND TO BY OB/GYN AND WAS TOLD THAT I HAD PID, THEN TOLD I DIDN'T HAVE IT, THE TOLD IT WAS A CYST ON MY RIGHT OVARY AND THEN THAT WAS GONE AND THEN THEY SAID THEY DIDN'T KNOW.
THEN ON JAN 15 2009 I FOUND I WAS PREGNANT. I WOKE UP IN THE MORNING AND I HAD HAD SOME SPOTTING AND I THOUGHT IT WAS UNUSUAL BECAUSE I HAD ALREADY HAD WHAT I THOUGHT WAS A PERIOD ABOUT A WEEK AND A HALF EARLIER. I MADE AN APPT WITH MY OBGYN AND HAD AN ULTRASOUND ON JAN 26, THEY COULDN'T SEE ANYTHING AND IT WAS TOO EARLY FOR A HEARTBEAT, OR SO THEY TOLD ME, AND SO I WAS SCHEDULED FOR A BLOOD TEST.
THEY TESTED BY HCG AND I GUESS MY LEVELS AND SAID THAT IT WAS LOW AND TO REPEAT THE TEST IN 2 DAYS. WHEN I WENT BACK THE NUMBERS WERE ONLY ABOUT 200 MORE THEN THEY WERE THE PREVIOUS TIME. I WAS TOLD THAT I COULD POSSIBLY LOOSE THE BABY AND THAT I NEEDED TO JUST WAIT AND SEE WHAT HAPPENED.
ON FEB 1 I WENT TO THE EMERGENCY ROOM BECAUSE I WAS BLEEDING, MORE THAN I THOUGHT I SHOULD BE ANYWAY. THEY DID ANOTHER ULTRASOUND AND MORE BLOOD WORK AND THEY CAME TO THE CONCLUSION THAT I HAD MISCARRIED BECAUSE THEY COULDN'T FIND ANYTHING IN MY TUBES EITHER. THEY GAVE ME ROGHAM, BECAUSE I'M RH NE AND SENT ME ON MY WAY.
I HAD A FOLLOW UP ULTRASOUND WITH MY OBGYN ON FEB 9 AND THATS WHEN SHE FOUND THE PREGNANCY IN MY TUBE. I HAD SURGERY ON FEB 11 AND THEY REMOVED MY RIGHT TUBE BY LAPORASCAPY AND A D %26 C. WHILE INSIDE THEY CHECKED MY LEFT TUBE TO MAKE SURE THAT IT WASN'T DISEASED ALSO AND SUPPOSEDLY ITS OK...
ITS BEEN ABOUT A YEAR SINCE THEN AND I HAVEN'T GOTTEN PREGNANT. MY HUSBAND AND I HAVE HAD UNPROTECTED SEX EVER SINCE WE'VE BEEN TOGETHER AND THATS BEEN A LITTLE OVER 2 YEARS.
I'M SORRY THIS IS SO LONG I'M JUST REALLY CONFUSED. I WANT THIS SO BAD. MY QUESTION IS, IS ALL OF THIS NORMAL, THE CHAIN OF EVENTS I MEAN? IS IT POSSIBLE FOR ME TO STILL GET PREGNANT? DO YOU HAVE ANY ADVICE ON WHAT, IF ANYTHING, I SHOULD DO TO SUCCEED? ANY INFORMATION WILL BE HELPFUL AND VERY APPRECIATED. THANK YOU SO MUCH FOR YOUR TIME.
PS I'M 21 IF THAT MAKES A DIFFERENCE AND MY HUSBAND IS 22.
AnswerHello Amanda from the U.S.,
You have what we call "tubal factor infertility." What this means is that the tubes are damaged and so pregnancy is not occurring. With a history of "possible" PID and an ectopic pregnancy, that means that there was some type of inflammation that caused damage to the internal structures of the tube. For this reason, the pregnancy got stuck and implanted into the tube, called an ectopic pregnancy. It is possible that this tube was partially open and so you were able to become pregnant naturally, but the opposite tube may be sufficiently damaged to render it non-functional. When I counsel patients, I usually will assume that the opposite tube is damaged as well because the infections/inflammation that affects one tube will usually affect the other. You can certainly do a test called an HSG (hysteroscalpingogram) to see if the tube is open, but the tube is not just a pipe and even if it is open, if the internal structures have been destroyed, then it will not work properly and pregnancy will not occur. Since it has been so long since your last pregnancy, I would assume that this tube does not work.
In this case, the only option that you have is an infertility treatment called IVF (In Vitro Fertilization). In this treatment, the eggs are removed directly from the ovaries, put together with the sperm, fertilized, allowed to grow into embryos and placed back into the uterus. This method bypasses the tubes and therefore, normal tubes are not required. It is the treatment of choice for you and has a pregnancy rate of 60-70% per attempt in your age group. That is what I would recommend.
I would recommend that you seek out a good infertility specialist that does IVF so that they can counsel you further and explain the procedure in detail.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV
