Ectopic pregnancies, and the loss of a fallopian tube, are things that are not discussed greatly when it comes to people’s fertility journey. You may be trying to conceive and struggling as a result of this. If so, this fertility blog article will be sharing Sarah’s story and what she went through when trying to conceive when she found out she would have to lose one of her fallopian tubes.
Over to our FHH reader and friend, Sarah Clark
Our Fertility Journey
It started in September 2018. After a long stint on the contraceptive pill (15 years +), we decided that it was the right time to think about trying to conceive. I came off the pill and never regained my regular cycle and, after 6 months of not having a period, I decided to visit my GP, who ran various fertility tests. Eventually, my GP sent me to a gynaecologist, who told me that I had unexplained infertility due to ‘anovulation’ and my best bet was to seek specialist fertility help.
In the UK, it’s normal practice with the NHS that as a couple you have to have been trying to conceive for two years before they will offer any kind of fertility treatment or fertility specialist help. As we didn’t want to wait that long, we decided to take the private route and met Mr K, a fertility specialist, in the late summer of 2019. He conducted his own fertility tests, including HyCosy (to check that the fallopian tubes are clear), before he prescribed me the drug Clomid, which stimulates ovulation. He too concluded that my infertility due to lack of cycles was unexplained. Strangely I actually had to go back on the contraceptive pill for three weeks to cause a ‘period’ before taking Clomid on days 2-6 of my cycle. I was carefully monitored by blood tests to make sure my body was responding correctly and we were sent on our merry way to make a baby! I was so happy to have a regular(ish) cycle back and then whilst we were TTC (trying to conceive), I started to use ovulation predictor kits to determine when I was ovulating, and started tracking my cycle through various apps.
Related Article – TTC – Charting Your Sex Hormones with Temperature
A Positive Pregnancy Test
Towards the end of October 2019, we excitedly told close family members and started making wild plans in our heads for our unborn baby. I downloaded every pregnancy app under the sun and started a mental baby shopping list. As it had taken us some time to fall pregnant, my husband Oli and I decided we would like to have an early 8 week scan with Mr K. In the meantime, I had booked my midwife appointment and registered online at the hospital maternity department for scans.
On the evening of December 5th we skipped into the hospital ahead of our scan, feeling a whole host of happy and excited emotions. Mr K sat us in his room and asked me various questions including ‘Do you feel pregnant?’ , to which I responded ‘I guess so, I’ve never been pregnant before but I have felt great.’ We were then led into the scanning room and I got myself into position for an internal scan as it was still relatively early in the pregnancy. Oli was sitting behind Mr K and a nurse, but he could see the screen clearly, so we were good to go. Having never been pregnant before, I honestly really had no idea what I was looking for on the screen, but when there was literally nothing to see, I knew something wasn’t right. Mr K remained very quiet throughout and, after clicking around and printing various photos, 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 back in his room. I remember worriedly looking at my husband whilst trying to get dressed and saying, ‘I’m so confused, I’m definitely pregnant. I did 6 tests’.
Mr K handed me a box of tissues and started to tell me that when a pregnancy cannot be seen in the uterus, it is known as a Pregnancy of Unknown Location (PUL) until it is investigated and diagnosed. There are several causes of this: either pregnancy dates are wrong and it’s too early to see an embryo; a missed miscarriage; or 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 Mr K would make the arrangements for me to be seen as a priority as my condition could be life-threatening. By process of elimination, Mr K believed I had an Ectopic Pregnancy which in all honestly was something I had barely heard of, let alone knowing what it was or meant. An ectopic pregnancy occurs when a fertilised egg implants and grows outside of the main cavity of the uterus, most often occurring in a fallopian tube, which carries eggs from the ovaries to the uterus. I was very sure my dates were correct and that I hadn’t experienced a miscarriage, but equally so, after frantically googling ‘ectopic pregnancies’, I didn’t believe that was correct either, as I hadn’t experienced any symptoms of an ectopic pregnancy.
Related Article – Baby Loss Awareness – What Not to Say to a Woman Who’s Had a Miscarriage
We left the hospital in a complete daze, trying to take in all the fertility help information that had just been thrown at us. I called my mum from the car park and, completely beside myself, tried to explain to her what was going on, which was particularly hard as I didn’t even really know myself. She was fully expecting me to call with good news and was understandably absolutely devastated for us. I was utterly heartbroken, I entered the scan on an all-time high and it all came crashing down very quickly. We got home and went straight to bed and I spent most of the night googling hopeful stories to see me through until the morning. At this stage, I was still really thinking the scan must have been wrong and our baby was just too small or hiding somewhere…
The Following Morning
The next morning we went to the EPU and waited patiently in a room with some other couples, who looked equally 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 if I had any adverse pregnancy symptoms. They then led me into a scanning room and I prepared myself for another internal scan where they confirmed they definitely could not see a baby in my uterus and, at 8 weeks pregnant, a baby would definitely be visible. I then had to have blood tests to measure my HCG levels, which would enable them to diagnose me officially with an ectopic pregnancy. After the blood tests, Oli and I were allowed to leave the hospital as I wasn’t in any pain, but was strictly told not to do any exercise or lift anything heavy as this can cause your fallopian tube to rupture and cause major internal bleeding. We had literally just pulled into our driveway when I received a call from the hospital telling me I needed to return immediately. My HCG levels were really high, over 5000, which is in line with a healthy pregnancy, meaning that the pregnancy was most likely still continuing and growing, and my chance of rupturing increased.
We arrived back in the EPU and 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 led into a ‘bad news’ room and was given two options:
Have an injection of Methotrexate – a chemo drug that stops cells from dividing and would therefore end the pregnancy, with the embryo being absorbed by my body. (However, as my HCG levels were so high, I was told that this option may not work but I could have a further injection a week later if needed)
To have Salpingostomy Surgery to remove the embryo, and most likely my right fallopian tube.
Both options meant that we wouldn’t be able to try to conceive for at least three months. What a decision!! After a lot of deliberation, we decided that I would have the injection as I didn’t want to volunteer myself for surgery when I wasn’t in any discomfort and, if I could avoid removing my fallopian tube, I would prefer that. The injection was rather uncomfortable and had to be done using a large needle in my buttock but I felt fine afterwards and was allowed go home.
The next week was a bit of an emotionally draining blur, but I had to go to the hospital every two days for further blood tests to make sure my HCG levels were decreasing. Halfway through the week I received a call to say my levels had increased but not to worry as this often happens after the injection and a decision would be made regarding next steps after the next blood draw. By the end of the week, my HCG levels were still on the rise and above a level where they could administer a further dose of Methotrexate. Therefore, I would need emergency surgery to remove the embryo and my right fallopian tube. I had to be transferred to Brighton Hospital EPU by ambulance, as that’s where they do the surgery I needed. This was not exactly what I had planned for the day! I had pulled myself together, put a nice outfit on and was hoping to go for lunch to ‘celebrate’ my nightmare ending.
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 but was told my surgery would not be until the following morning, as it was so late in the day. That evening, I began feeling really unwell and started to bleed. I was subsequently put on strong painkillers for the night and had a great night’s sleep at least! The next day, I had my pre-op assessment early and was told I was high priority and would be the first surgery of the day. The surgeon would be doing the rounds soon to introduce themself. To my utter delight, Mr K (my private consultant) popped his head around my curtain and told me that he would be doing my surgery (he also works for the NHS). I instantly felt so much happier and more positive knowing that someone I fully trusted would be performing the surgery that I was really dreading. Before I went down to theatre, I had to sign a final form which stated that I gave permission for my ovary to be removed too, should the need arise. The last thing I remember was chatting away to the anaesthetists and asking them to tell Mr K to try his hardest to not remove my ovary too!
I woke up a couple of hours later and was told that the surgery went as expected, with the removal of my right fallopian tube, but thankfully not my ovary. The fertilised egg had implanted much further into my fallopian tube than first thought, so it definitely needed to be removed, it was a cyst by my ovary that had been picked up on the ultrasound. Mr K came to visit me later on and reassured me all had gone to plan, explaining that I should be able to conceive successfully still with one fallopian tube. I was amazed to learn that some women can become pregnant from the ovary on the tubeless side, as the remaining tube creates a vacuum to suck in the eggs. I was discharged the same day as my surgery and arrived home to a letter from the maternity unit with the date for my 12 week scan which felt like a giant kick in the teeth, just bad timing! After this I asked Oli to do a sweep of the entire house to remove absolutely anything pregnancy related. I deleted all the apps I had stupidly downloaded and tried to block the weekly pregnancy update emails coming into my inbox.
My Support Network
My family and friends were incredible during this extremely difficult time and I found great fertility help and support through Ectopic.org as well as Fertility Help Hub and the various Facebook support groups that are available. It still astounds me that this happens to 1 in 80 women and yet it is hardly ever spoken about. I also find it unbelievable that no-one can tell me why this happened to me – there doesn’t seem to be much understanding around the subject at all. I’m sure other people in similar positions can relate to this, whether you are anxiously enduring the two week wait (2WW), or struggling with an ectopic pregnancy, but you suddenly become so much more aware of people being pregnant around you and it seems like everyone in the world is announcing their happy news apart from you. I had friends who were worried about telling me they were expecting and friends who had newborns who were concerned that I wouldn’t want to be around them, and I became quite self-conscious of this. I spent a huge amount of time worrying about our future, until a good friend told me that dwelling on the future only adds to stress and anxiety about scenarios which may or may not happen, and this honestly transformed my mind-set and allowed me to move forward and get on with my life.
Fast forward to 8 months later, and now I am healthily 15 weeks pregnant. I feel so ridiculously lucky to be in this position, as I know many other women suffer multiple ectopic pregnancies, which was one of my biggest fears. I had also convinced myself that getting pregnant would be really difficult now with only one tube. My experience definitely created a lot of anxiety about being pregnant and I am constantly worrying that something will go wrong. The lead up to the early placement scan at 7 weeks was awful, I practically went to the hospital with an overnight bag packed, as I was convinced it would be another ectopic. Due to my history of a previous ectopic pregnancy, I will always have to go to the EPU for an early scan whenever I fall pregnant. In some ways this is great, but on the other hand I associate that ward with a very difficult time in our lives that isn’t good to revisit or think about. I have now had 3 scans with my current pregnancy and have finally been able to relax a little. I am really trying my hardest to enjoy being pregnant again and we are both so excited to welcome our new family member in early 2021!
Hopefully this fertility blog article has helped you gain a better insight into ectopic pregnancies and the removal of a fallopian tube. If you are going through this yourself, make sure to join our wonderful supportive community, Fertility Squad, to meet and connect with others facing similar challenges.