WHAT FERTILITY AFTER UTERINE PREGNANCY?

Today, an ectopic pregnancy rarely puts in question fertility. Moreover, according to obstetricians-gynecologists, 60% of women who have an ectopic pregnancy are pregnant again within two years after.

So how do we preserve fertility after an ectopic pregnancy?

We speak of ectopic pregnancy when the fertilized egg implants outside the uterus, usually in the fallopian tube. The embryo can not develop outside the uterus and it can damage the tissues in which it operates, which can cause pain in the lower abdomen and bleeding (blood loss Dark) could bring significant life of the pregnant woman at risk.


The ectopic pregnancy is an emergency!

It should be an abortion. Depending on the stage of discovery of ectopic pregnancy, one can resort to various treatments, more or less conservative, which will most often to preserve fertility and thus the opportunities for a new pregnancy.

Approximately 2% of pregnancies are ectopic pregnancies, or 14,000 cases per year in France.
The ectopic pregnancy is unpredictable and causes are not always known. However, there are risk factors: a history of endometriosis, ectopic pregnancy, surgical intervention in the reproductive organs, infection of the fallopian tubes, drug treatment to stimulate ovulation, and smoking.

Sexually transmitted infections can damage the reproductive organs and promote ectopic pregnancies.


What are the treatment of ectopic pregnancy?

Depending on the stage of ectopic pregnancy, the medical or surgical treatment will be more or less conservative.

Medical treatment preserves future fertility

In early forms of ectopic pregnancy may be considered a methotrexate: injected into the tube, this molecule blocks the growth of the egg cell and destroys existing cells. This procedure is done under general anesthesia, but does not require hospitalization. The patient leaves on the same day, but followed up during a fortnight is set up.

This treatment does not affect future fertility. Another pregnancy can be considered a few months later.

Surgical treatment, more or less conservative

When the egg has reached a more advanced stage, with high risk of rupture of the fallopian tube, is surgical intervention. It is held by laparoscopy.

Depending on the condition of the tube affected, it will be retained or removed, a decision which is also based on the good condition of the other wrong. Fertility can be preserved most often but not always.

 There is talk of radical surgery, which involves removal of the tube (salpingectomy) and may enable a future pregnancy to the sole condition that the other mistake is in good condition. And conservative surgery, which is based on salpingotomy: the horn is incised to remove the egg by suction, but left in place and therefore preserved.
In rare cases, the uterus is so damaged that it must perform a hysterectomy (removal of the uterus), thus preventing any pregnancy permanently.