Pregnancy after fallopian tube removal – Sarah’s story
Our journey to conception, after tube removal
Ectopic pregnancies – and the loss of a fallopian tube – can be something of a shadow topic, when sharing fertility journeys.
If this is part of your story, trying to conceive may be more difficult as a result.
Today’s post shares Sarah’s story and what she went through when she discovered she would need to lose one of her fallopian tubes while trying to conceive.
Over to our TRB reader and friend, Sarah Clark.
How we started
In September 2018 – after a long stint on the contraceptive pill (15+ years) – my husband Oli and I decided it was the right time to start thinking about trying to conceive.
I came off the pill but never regained a regular cycle. After six months without having a period, I decided to visit my GP, who ran various fertility tests.
Eventually, my GP referred me to a gynaecologist, who told me I had unexplained infertility due to anovulation and that my best option was to seek specialist fertility support.
In the UK, it’s normal NHS practice that couples must have been trying to conceive for two years before they’re offered any form of fertility treatment or specialist support.
As we didn’t want to wait that long, we decided to go privately and met with a fertility specialist, in late summer 2019. He carried out his own fertility tests and checked my fallopian tubes were clear, before prescribing the drug Clomid to stimulate ovulation. Like my GP, he concluded that my infertility (caused by a lack of cycles) was unexplained.
Strangely, I actually had to go back on the contraceptive pill for three weeks to trigger a ‘period’ before taking Clomid on days 2-6 of my cycle. I was carefully monitored through blood tests to ensure my body was responding correctly, and then we were sent on our merry way to ‘make a baby’.
I was so happy to have a regular(ish) cycle again. While we were TTC (trying to conceive), I also started using ovulation predictor kits to work out when I was ovulating and began tracking my cycle through various apps.
A positive pregnancy test
Towards the end of October 2019, our hopes were realised with a positive pregnancy test – we were over the moon. While excitedly sharing the news with close family members, we started making wild plans in our heads for our unborn baby. I downloaded every pregnancy app under the sun and began a mental baby shopping list.
As it had taken us some time to fall pregnant, we decided we would like to have an early eight-week scan with our fertility specialist. In the meantime, I had booked my midwife appointment and registered online with the hospital maternity department for my scans.
On the evening of December 5th, we skipped into the hospital ahead of our scan, full of happy and excited emotions. Quite early on, our specialist sat us down and asked me various questions, including, “Do you feel pregnant?”, to which I replied, “I guess so. I’ve never been pregnant before, but I’ve felt great.”
We were then led into the scanning room and I got into position for an internal scan, as it was still relatively early in the pregnancy. Oli sat behind our specialist and a nurse, but he could see the screen clearly, so we were good to go.
Having never been pregnant before, I honestly had no idea what I was supposed to be looking for on the screen. But when there was literally nothing to see, I knew something wasn’t right.
Our specialist remained very quiet throughout. After clicking around and printing various photos, he finally said to us, “I am so sorry to tell you this, but I cannot see a baby in your uterus.”
He then asked me to get dressed and meet him back in his room. I remember worriedly looking at my husband while trying to get dressed and saying, “I’m so confused. I’m definitely pregnant. I did six tests.”
Our specialist handed me a box of tissues and explained that when a pregnancy can’t be seen in the uterus, it’s referred to as a pregnancy of unknown location (PUL), until it has been properly investigated and diagnosed.
There are several possible reasons for this: the pregnancy dates may be wrong and it’s simply too early to see an embryo, it could be a missed miscarriage, or it may be an ectopic pregnancy.
I was told I needed to go to the Early Pregnancy Unit (EPU) at my local hospital first thing the next morning, and that our specialist would arrange for me to be seen as a priority, as my condition could be life-threatening. Through a process of elimination, he believed I had an ectopic pregnancy – something I had barely heard of, let alone understood.
An ectopic pregnancy occurs when a fertilised egg implants and grows outside of the main cavity of the uterus. It most often develops in a fallopian tube, which carries eggs from the ovaries to the uterus.
I felt sure my dates were correct and that I hadn’t had a miscarriage. But equally, after frantically searching ‘ectopic pregnancies’ online, I wasn’t convinced that was the answer either, as I hadn’t experienced any of the symptoms typically associated with one.
We left the hospital in a complete daze, trying to process everything that had just been thrown at us.
I called my mum from the car park and, completely beside myself, tried to explain what was happening – which was especially hard as I didn’t really understand it myself.
She had been expecting a call with good news and was, understandably, absolutely devastated for us. I was heartbroken. I had walked into the scan on such a high, and it all came crashing down so quickly.
When we got home, we went straight to bed. I spent most of the night searching online for hopeful stories, to get me through until the morning.
At that point, I still truly believed the scan must have been wrong, that our baby was just too small to be seen – or even ‘hiding’ somewhere.
The following morning
The next morning, we went to the EPU and waited patiently in a room alongside other couples who looked just as upset and worried.
I was called into an examination room and asked a number of questions about the date of my last period and whether I’d experienced any concerning pregnancy symptoms. I was then taken into a scanning room and prepared myself for another internal scan. They confirmed they definitely could not see a baby in my uterus and that, at eight weeks pregnant, a baby would absolutely have been visible.
I then had blood tests to measure my HCG hormone levels, which would help them officially diagnose an ectopic pregnancy.
After the blood tests, Oli and I were allowed to leave the hospital as I wasn’t in any pain. However, I was strictly told not to exercise or lift anything heavy, as this could cause the fallopian tube to rupture and lead to major internal bleeding.
We had literally just pulled onto our driveway when I received a call from the hospital telling me I needed to return immediately. My HCG levels were very high – over 5,000 – which was more in line with a healthy pregnancy. This suggested the pregnancy was still continuing and growing, increasing my risk of rupture.
When we arrived back at the EPU, I was re-scanned by a more senior sonographer, who believed she had located the embryo at the bottom of my right tube, close to my ovary.
I was then taken into yet another room and given two options:
- Have an injection of methotrexate – a chemotherapy drug that stops cells from dividing and would therefore end the pregnancy, with the embryo then being absorbed by my body. However, because my HCG levels were so high, I was warned this option might not work and that I may need a second injection a week later.
- Have salpingostomy surgery to remove the embryo and, most likely, my right fallopian tube.
Both options meant we wouldn’t be able to try to conceive again for at least three months. What a decision to have to make.
After a lot of deliberation, we decided I would have the injection. I didn’t want to volunteer myself for surgery when I wasn’t in any discomfort and, if there was any chance of avoiding the removal of my fallopian tube, I wanted to take it.
The injection itself was quite uncomfortable and had to be administered with a large needle into my buttock, but afterwards I felt fine and was allowed to go home.
The next week was a bit of an emotionally draining blur. Every two days, I had to return to the hospital for more blood tests to check whether my HCG levels were decreasing.
Halfway through the week, I received a call to say my levels had actually increased. I was told not to worry, as this can often happen after the injection, and that a decision on next steps would be made after my next blood draw.
By the end of the week, however, my HCG levels were still rising and had gone above the level at which they could safely administer another dose of methotrexate. As a result, I was told I would need emergency surgery to remove both the embryo and my right fallopian tube.
I then had to be transferred by ambulance to the EPU at Brighton Hospital, as that was where the surgery I needed was carried out.
It was definitely not how I had imagined the day going. I had finally pulled myself together, put on a nice outfit, and was hoping to go out for lunch to ‘celebrate’ the nightmare finally being over.
My fallopian tube removal surgery
After a long day in Brighton A&E with Oli and my mum, I finally got a bed in the EPU. However, I was told my surgery wouldn’t take place until the following morning, as it was already so late in the day.
That evening, I started to feel really unwell and began bleeding. I was given strong painkillers for the night and, at the very least, managed to get a good night’s sleep.
The next morning, I had my pre-op assessment early and was told I was high priority and would be the first surgery of the day. I was also told the surgeon would soon come around to introduce themselves.
To my absolute relief, our private consultant appeared around the curtain and told me he would be performing my surgery after all (he also works for the NHS).
Instantly, I felt calmer and far more positive knowing that someone I trusted completely would be carrying out the surgery I had been dreading.
Before I went down to theatre, I had to sign a final consent form confirming that, if necessary, my ovary could also be removed. The last thing I remember was chatting away to the anaesthetists and asking them to tell my specialist to try his hardest not to remove my ovary too.
A couple of hours later, I woke up and was told the surgery had gone as expected. My right fallopian tube had been removed, but thankfully my ovary had been saved.
The fertilised egg had implanted much further along the fallopian tube than they had first thought, so it absolutely needed to be removed. What had initially appeared on the ultrasound near my ovary turned out to be a cyst.
Later on, our specialist came to see us, and reassured me that everything had gone to plan. He explained that I should still be able to conceive successfully with one fallopian tube.
I was amazed to learn that some women can still become pregnant from the ovary on the side without a tube, as the remaining tube can effectively create a vacuum and pick up the egg.
I was discharged later the same day. When I arrived home, there was already a letter waiting from the maternity unit with the date of my 12-week scan – a badly timed and painful reminder of everything that had happened.
After that, I asked Oli to go through the house and remove absolutely anything pregnancy-related.
I deleted all the apps I had downloaded and tried to block the weekly pregnancy update emails that were still landing in my inbox.
My support network
My family and friends were incredible throughout such a difficult time. I also found a huge amount of fertility support through Ectopic.org, The Ribbon Box, and the various Facebook support groups available online.
It still astounds me that ectopic pregnancies affect around one in 80 women, and yet they are hardly ever talked about.
I also found it unbelievable that nobody could really tell me why it had happened. There still seems to be such little understanding around the subject.
I’m sure others in similar situations can relate to this, whether you’re anxiously enduring the two-week wait or navigating an ectopic pregnancy yourself, but suddenly you become hyper-aware of pregnancy all around you. It can feel as though everyone else is announcing happy news while you’re quietly struggling.
I had friends who worried about telling me they were pregnant, and friends with newborns who were concerned I wouldn’t want to be around them. In turn, I became very self-conscious about how I might come across.
I spent a huge amount of time worrying about the future, until a good friend told me that dwelling on what might happen only adds more stress and anxiety to situations that may never even occur. That advice genuinely transformed my mindset and helped me start moving forward and getting on with my life.
Fast-forward eight months
Just over half a year on from my tube removal, I am now happily and healthily 15 weeks pregnant. I feel incredibly lucky to be in this position, especially as I know many women sadly go on to experience multiple ectopic pregnancies, something that became one of my biggest fears.
I’d also convinced myself that getting pregnant again would be really difficult with only one tube. The whole experience created a huge amount of anxiety around pregnancy, and I still constantly worry that something might go wrong.
The lead-up to my early placement scan at seven weeks was awful. I practically arrived at the hospital with an overnight bag packed because I was so convinced it would be another ectopic pregnancy.
Because of my history, I will always need to attend the EPU for an early scan whenever I become pregnant. In some ways, that reassurance is really helpful, but at the same time, I strongly associate that ward with one of the hardest periods of our lives, which can be difficult to revisit emotionally.
I’ve now had three scans during this pregnancy and have finally started to relax a little. I’m really trying to enjoy being pregnant again, and we are both so excited to welcome our new family member.
