QuestionQUESTION: Hello,
I hope you would be able to help me.I had an ectopic pregnancy 3 months back wherein i had to undergo laproscopy surgery to remove my right fallopain tube where the fertilized egg had embedded.Both my ovaries are intact.I didn't have any fertility issues before conceiving.
> My question is whether it is possible for left fallopian tube to collect the eggs released by right ovary.
> Also, wanted to check whether the ovaries release eggs in alternate months.
> In your opinion approximately how long it might take for me to conceive the next time.
Please help me with these questions
ANSWER: Hello Vanhih from India,
In answer to your questions, yes, it is possible for an egg that is ovulated from the right side to enter through the left tube. That is because no matter what side the egg ovulates from, it falls into a space in the middle, called the culdesac, where the end of the tubes are usually hanging. Eggs are released randomly from the ovaries. They do not alternate. The problem that you have is that you had an ectopic pregnancy. This is usually caused by scar tissue within the fallopian tube. The egg/embryo gets stuck on this scar tissue and cannot advance, therefore, it implants there. If you have scar tissue on one side, you are at risk for having scar tissue on the opposite side because usually the inflammation that affects one tube, also affects the other tube (that is where the scar tissue came from). For that reason, you are at increased risk of another ectopic on the opposite side. Your chances of getting pregnant are still the same, despite only having one tube, but you have a 30-50% chance of an ectopic. The treatment that I would recommend at this point would be to consider IVF so that the tubes can be bypassed.
Sincerely,
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 facebook and twitter with me at @montereybayivf
---------- FOLLOW-UP ----------
QUESTION: Hello,
Thank you for the Response.
In my previous mail, i hadn't mentioned about the HSG test which says that my left fallopian tube is intact and there is free flow of dye from the tube
(i had also taken a secondary opinion from one of the radiologist(Dr. Raghav) from wockharth hospital who confirmed that the left tube was fine and insisted on trying out before next decision.
My question here is
1. What are the chances of Ectopic with the above information?
2. What are the early symptoms of ectopic pregnancy to look out for?
3. How long do i wait before going for IVF?
AnswerHello Again,
I am sorry that my previous answer was not clear enough. You have a 30-50% chance of ectopic pregnancy despite the HSG result. The HSG, where dye is injected to see if the tube is open, can only see the dye passed through radiologically. It cannot see minute defects such as adhesions within the tube (on the xray you only see a thin line passing in the direction of the tube. You can't even really see the tube#. Also keep in mind that fluid can flow through even the smallest opening or crack, so unless the tube were completely blocked, the dye would flow through and the tube would look open. That does not mean the the tube is still functional or that there are no adhesions/scar tissue within.
The only way that you can know if you can get pregnant with that tube is to try for pregnancy.
Ectopics generally do not produce symptoms until late. That is close to rupture. For that reason, if you are at increased risk of an ectopic, like you are, I would recommend that you see your doctor as soon as you miss your period so that he/she can begin an evaluation to rule out ectopic pregnancy. That is done with serial blood tests bHCG) and pelvic ultrasound.
In order to do IVF, you only have to wait a minimum of 6 weeks from your surgery.
I hope this answers your questions.
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 facebook and twitter with me at @montereybayivf
