Trying for a baby after an ectopic pregnancy

I would be very grateful if you could possibly give myself and my wife any tips or advice on how to achieve a successful conception. My wife has had an ectopic pregnancy in the past.

Unfortunately following an ectopic pregnancy the chances of conceiving are reduced even when the fallopian tube did not need to be removed. The delicate lining of the tube, as you say will have been scarred by the ectopic pregnancy, making it harder for the egg to pass down the tube.

In such situations it is often advisable to discuss the planning of a pregnancy with a fertility specialist. If you have not already done so it may be an idea to discuss this with your GP and to ask about a referral to a fertility clinic.

The miscarriage association and the Ectopic Pregnancy Trust have informtion which you may also find helpful at the following links.

http://www.miscarriageassociation.org.uk/ma2006/information/leaflets/ectopic.htm
http://www.ectopic.org

Regarding trying to conceive the findings of a study into periods of fertility within the menstrual cycle reported in the British Medical Journal in 2000 may be useful to you.

According to this and other sources there are a number of days within the cycle where intercourse can result in a pregnancy, the so-called "fertile window”, i.e. six days; comprising of the five days before ovulation and the day of ovulation itself.

The study found that only a small percentage of women ovulate 14 days before the next period of menstruation, and that 70% were in their 'fertile window' before the 10th or after the 17th day of the menstrual cycle (day 1 being the first day of bleeding).

Therefore, just as the day of ovulation varies from cycle to cycle so does the timing of the six fertile days, and it is the fertile window that is significant as far as timing is concerned.

Because of the uncertainty in predicting ovulation/fertile window the recommendation to couples resulting from this study is to indulge in intercourse 2-3 times per week to maximise their chances of conceiving.

However, pregnancy depends on other factors as well as intercourse in this period, such as the viability of egg and sperm, the receptivity of the uterus, and other issues that vary from couple to couple.

At midwivesonline we have compiled some basics tips to improve general health when thinking about starting a family:

• Diet - it is a good time to think about what you are eating. Check to see if you are eating a healthy balance of fresh fruit, vegetables, carbohydrate and proteins. If possible it would be good to cut down on fast-food or convenience foods.
• Vitamins and minerals - you may want to consider taking a folic acid supplement as this may reduce the risk of your baby having a neural tube defect such as spina-bifida.
• Rubella vaccine - this is a vaccine that prevents ‘German measles’. You may have had this at school when you were a teenager. Your doctor can check your immunity levels by doing a simple blood test and if your levels are low you will be offered the vaccine. Think about having the vaccine prior to conception as Rubella in early pregnancy may cause fetal abnormalities.
• Exercise - gentle regular exercise will keep you fit and healthy but there is no need embark upon a new and demanding exercise routine. If you are currently exercising then continue as before. Swimming is an excellent and enjoyable form of exercising in pregnancy.
• Smoking - one of the best things you can do for yourself and your baby is to give up completely. This includes your partner. Some find it easier to stop rather than cut down.
• Alcohol - The best way is to give up alcohol completely whilst you are preparing for pregnancy to occur.
• Drugs and medication - you may let your doctor know if you are planning to start a family and avoid all drugs and medication unless they are prescribed by your doctor.
• Stress - high levels of stress can be linked to infertility so if you are planning to have a baby you may want to look at ways to reduce stress in your life

Remember that you can always make an appointment with your doctor, midwife, health visitor or your local family planning clinic for pre-conceptual advice or ask for a referral to a specialist fertility clinic.