Ectopic Pregnancy: Diagnosis and Treatment

Regardless of the method chosen to treat an ectopic pregnancy, the woman's blood hCG levels must be followed until they are undetectable. Once the levels are negative, she should wait three months for tubal healing to occur (unless the tube was removed) before trying to conceive again. Since her fertility potential may be diminished and since her odds of a subsequent ectopic pregnancy are increased following an ectopic pregnancy, a patient should not try too long to conceive without success (generally 3-6 months) before seeking the assistance of a fertility specialist. It may be necessary to "bypass" the fallopian tube(s) and undergo in vitro fertilization (IVF).

Even if she conceives via IVF, a woman with a history of tubal pregnancy has at least a 5% chance of a repeat ectopic pregnancy. Therefore, early pregnancy monitoring (via blood testing and ultrasound) is critically important for all women with this history. Finally, should a woman conceive naturally, she should seek early medical attention to decrease her risk of disaster and increase her odds of present and future reproductive success.

Conclusion

The advent of modern diagnostic and therapeutic modalities has changed the clinical scenario of ectopic pregnancy from one of possible disaster (and even death) to one of potential success. It is important to remember that every woman of reproductive age is at a potential risk for having a tubal pregnancy. Women who heighten their awareness of the signs and symptoms of an ectopic pregnancy will help their doctors to make the diagnosis earlier, treat the problem with less invasive methods, preserve the fallopian tubes, and greatly increase the odds of achieving a healthy and fruitful outcome.

Dr. Scott Roseff is the Director of the West Essex Center for Advanced Reproductive Endocrinology (W.E. C.A.R.E.) in West Orange, New Jersey. Following his graduation from the UAG School of Medicine, he completed a one year rotating "Internship" in Internal Medicine, General Surgery, Pediatrics, Psychiatry, and Obstetrics/Gynecology at St. Barnabas Medical Center in Livingston, New Jersey. His Residency training in Obstetrics and Gynecology was performed at The Stamford Hospital in Stamford, Connecticut. He then went on to complete his Postgraduate Fellowship in Reproductive Endocrinology and Infertility at The UCSD School of Medicine, San Diego, California, after which he achieved Board Certification in the specialty of Obstetrics and Gynecology, as well as in the subspecialty of Reproductive Endocrinology and Infertility.

Dr. Roseff's research and special areas of interest include the mechanisms of action of clomiphene citrate (Clomid/Serophene), the hormonal dynamics of the menstrual cycle, laser laparoscopy, endometriosis, abnormal sperm function, polycystic ovarian syndrome (PCOS), and menopause (to name just a few). Dr. Roseff maintains active staff privileges in the Ob/Gyn Departments at St. Barnabas Medical Center (Livingston, NJ) and at Morristown Memorial Hospital (Morristown, NJ).

Copyright © Scott Roseff. Permission to republish granted to Pregnancy.org, LLC.