Pregnancy after ectopic pregnancy

Dear Professor Winston,

I have one child, conceived naturally 4 years ago. 2 years later I had a missed ectopic pregnancy that ruptured, resulting in my left fallopian tube being removed by emergency surgery. One year later (last October 2017) I conceived naturally but suffered another ectopic pregnancy this time in my right tube but it resolved itself and no intervention was required.

We have since has 1 round of IVF, two embryos implanted at day 3… The pregnancy test was positive but a few days later I miscarried.

Having read your latest book, I still wonder if I should have my remaining tube looked at to see its condition, what are you thoughts please?

Any advice or thoughts would be greatly appreciated. Thank you.

Kind regards


Dear I.,

It is probably not worth attempting to repair your remaining tube after two ectopics. In the very early days of IVF when it not was very unsuccessful, we had very occasional success repairing a remaining tube with microsurgery. But I think I am inclined to suggest IVF again. Statistically this has a better chance by far and as you have already had one child and at least two other pregnancies, thg likelihood that IVF will produce an embryo which will implant successfully is high. One round of IVF which failed is not a failure of the treatment and I would suggest that persist with further cycles even though this tosd demanding and expensive. It is going to be your best chance of another child even though you might conceive naturally.

Please bear in mind that whatever you do – even with IVF – there is a chance of another ectopic. But I would recommend that whatever you do you should leave the remaining tube in place even though some clinics advise tying off or even removing such tubes. This does not completely prevent another ectopic as after any embryo transfer an embryo can still move from from the uterine cavity and lodge and implant in the wall of the uterus where the remnant of the tube runs through it. This isn’t very likely but if you have had an ectopic previously it is always important to have scans if you get pregnant after an embryo transfer as the damaged stump of the tube (which cannot be removed without weakening the uterus) still provides a little passage into which an embryo can travel.

Very best wishes,

Robert Winston