Having one
ectopic pregnancy increases your risk of having
another ectopic pregnancy. When an ectopic pregnancy grows in a
fallopian tube, it damages the surrounding tubal
tissue, making it more likely that a fertilized egg will lodge there in the
future. But early detection and treatment can minimize the damaging effects of
an ectopic pregnancy. If you have surgery for an ectopic pregnancy, scar tissue
from that surgery also raises your risk of another ectopic pregnancy.1
Having a uterine pregnancy after an ectopic is a good sign that you
have a low risk of having another ectopic pregnancy later on.
Future fertility
Your future fertility and your risk of having another ectopic
pregnancy will be affected by your own combination of risk factors. These can
include smoking, use of
assisted reproductive technology (ART) to get
pregnant, and how much fallopian tube damage you have.
Early detection is the key to avoiding new tube damage. If the
embryo has no heartbeat, your pregnancy hormone (hCG) is low enough, and you
are not bleeding, you can choose methotrexate treatment instead of surgery.
Generally, avoiding surgery gives you a better chance of preserving your
fertility.
As long as you have one healthy fallopian tube, salpingostomy
(small tubal slit) and salpingectomy (part of tube removed) have about the same
effect on your future fertility. But if your other tube is damaged, your doctor
may try to do a salpingostomy. This may improve your chances of getting
pregnant in the future.2
If you become pregnant and are at high risk for ectopic pregnancy, you will be closely monitored. Health professionals
do not always agree about which risk factors are serious enough to watch
closely. But research suggests that risk is serious enough if you have had a
tubal surgery or an ectopic pregnancy before, were exposed to the chemical
DES (diethylstilbestrol) before birth, have known
fallopian tube problems, or have a pregnancy with an
intrauterine device (IUD) in place.3