Against the odds: Life after ectopic pregnancy

Annemarie Eade had her life all planned out. Now 38 and living in Kilbrittain, Co Cork, she and her husband Tony were married in 2009. “Our next step was babies,” she says. “We’d been planning it that way for years and hoped to have a honeymoon baby. Little did we know.”

Things went to plan at first Annemarie discovered she was pregnant while they were on honeymoon in New York.

The couple’s elation didn’t last long. Annemarie started spotting and they rushed to hospital as soon as they arrived back in Ireland. “A scan showed there was nothing in my womb and after taking my bloods, I was sent home to rest from what we thought was a miscarriage,” she says.

The following day, she was called back to have her bloods retested. The initial sample indicated she was still pregnant. “It was confusing,” says Annemarie. “I knew in my heart there was no baby but I wanted to believe a mistake had been made with the scan.”

There was no mistake. She was having an ectopic pregnancy, a rare occurrence that can lead to fertility complications. Annemarie was just beginning what would prove to be a long journey to motherhood.

“About 1% of pregnancies in Ireland are ectopic,” explains fertility specialist Dr John Waterstone, medical director of Waterstone Clinic. “They occur when the fertilised egg implants not in the uterine cavity as it should but somewhere else, usually in the fallopian tube.”

In most cases, the cause is unknown. “They occur in normal fallopian tubes and do not run in families,” says Dr Waterstone.

There are risk factors that can make ectopic pregnancy more likely. Surgery, appendicitis, endometriosis, or pelvic inflammatory disease can damage the fallopian tubes. A previous ectopic pregnancy means there’s slightly higher risk of another. IVF increases the risk and so does using an intra uterine contraceptive device.

Annemarie had none of these risk factors but her baby was growing in one of her fallopian tubes. “Because it was still early in the pregnancy, I didn’t need to have the tube removed,” she says. “I was given an injection and it was all over.”

She and Tony soon started trying to conceive again. But this time, it wasn’t so easy. Months and months passed with no result. After a year of trying, they approached the Waterstone Clinic. There, she was booked in for a routine laparoscopy and dye test. This test checks for blockages in the fallopian tubes. “They inject dye into the tubes and it should go in and come back out again,” says Annemarie. “But with me, the dye wouldn’t go through and it was clear that there was a problem.”

Despite subsequent testing, it never became clear what that problem was. “All we knew was that it was now more likely we’d need IVF to have our babies,” says Annemarie.

Then a surprising thing happened. she got pregnant. However, the pregnancy followed the same pattern as the first: Spotting followed by a diagnosis of ectopic pregnancy.

“My heart broke when they told us to try again and I wondered if I’d be able for a pregnancy failing a third time,” she says. “That was when we decided it might be better to try IVF.”

Women who have had ectopic pregnancies follow the same IVF procedure as women who have not. They take hormonal injections to encourage the growth of multiple eggs. Those eggs are removed and fertilised with sperm and if an embryo is successfully created, it is transferred into the woman’s womb.

IVF worked for Annemarie but she didn’t believe she was pregnant until they had their six-week scan. “I was so used to scans showing nothing and this time there was a blob — our blob.”

The pregnancy passed without incident and the couple’s daughter Madison was born in June 2013. At that stage, they had one embryo in storage and a year or so after Madison was born, they had it transferred. The procedure worked but the six-week scan showed there was nothing in her womb.

“It wasn’t an ectopic; the pregnancy just wasn’t viable,” she says. “It was another low point for us. The years we were trying for babies were all like that: Going from high to low to high to low.”

They started a second cycle of IVF but it wasn’t successful. “I was inconsolable when I got my period that time,” remembers Annemarie.

They tried a third time but by now they were worrying about the cost. Like most health-insurance policies, Annemarie’s provided limited fertility cover. She received a one-off payment of €1,000 for the first cycle.

“I was afraid of what would happen if the third cycle didn’t work,” she says. “I didn’t know if we could afford a fourth.”

She didn’t have to worry as the third cycle succeeded and their son Parker was born in February 2016. “Then we had one of each and we were the luckiest people in the world.”

Looking back, she still doesn’t know why having children was so difficult for her. “I’d always had irregular periods but other than that, nothing was wrong,” she says. “There’s no reason why I should have had ectopic pregnancies.”

www.ectopicireland.ie

FACT FILE

• Ectopic pregnancy is a life-threatening condition affecting approximately 1% of pregnancies.
• Ectopic means out of place and an ectopic pregnancy is one which implants outside of the uterus. 95% of ectopic pregnancies occur in the fallopian tube but it is possible to have an ectopic pregnancy in the ovaries, cervix or abdomen.
• The symptoms of ectopic pregnancy are just the same as for regular pregnancies. It is not until the foetus begins to grow that symptoms begin to occur.
• Symptoms can include abdominal pain, vaginal bleeding, pain or diarrhoea during a bowel movement, pain when passing urine, nausea and feeling light headed or faint. If not treated the ectopic pregnancy can rupture and cause severe bleeding which can be fatal.
• An ectopic pregnancy cannot be saved. Treatment options depend on the size and age of the pregnancy. If there is any risk of rupture it must be removed.
• In some cases, the pregnancy does not progress and it may be possible to manage without surgery. In other cases, the surgeon may perform keyhole surgery under general anaesthetic to remove the pregnancy. If the tube is damaged or if there is significant bleeding, the tube may have to be removed too.
• If the ectopic pregnancy is not diagnosed early or if the woman presents with severe symptoms, open abdominal surgery may be necessary. In this case, it is unlikely the tube will be saved.
• In some other cases, a drug called methotrexate is given in injection form to treat the ectopic pregnancy.
• If your fallopian tube and/or ovary is removed, your fertility may be affected. The majority of women who have one tube left are pregnant again within 18 months of trying. Those that aren’t can try fertility treatments such as IUI. However, if both tubes are removed or if there are complications, IVF may be the only option.
• Women who have had previous ectopic pregnancies are at higher risk of having another. Therefore they should have an early pregnancy scan, at five or six weeks’ gestation. Once the pregnancy is established, no special care is required for mother and baby. The pregnancy should progress the same as any other.

Link:http://www.irishexaminer.com/lifestyle/healthandlife/parenting/against-the-odds-life-after-ectopic-pregnancy-457222.html