Desiring to get pregnant can trigger a lot of questions and doubts, especially when dealing with chronic health issues. This overwhelming situation applies to women who suffer from PCOS, a hormonal disorder that can affect their mood, skin, and menstrual cycle.
Women living with PCOS need to take their health seriously if they aspire to have a healthy pregnancy. It’s essential to be aware that the chances of having an ectopic pregnancy are higher than the rest of the population, as well as an increased risk of gestational diabetes and preterm labor.
Life with a PCOS diagnosis can be challenging, like a roller coaster of emotions. In this article, we will talk about a sad but possible moment: experiencing an ectopic pregnancy when you have PCOS.
- What are the signs of an ectopic pregnancy?
- What do PCOS and ectopic pregnancy have in common?
- Should I try to get pregnant again after an ectopic pregnancy?
Table of Contents
What is an Ectopic Pregnancy?
After egg fertilization, the developing embryo (called a blastocyst, at this time) implants in a specific place in the womb (the uterus) to continue its development, to become a baby. However, sometimes the implantation plan goes wrong, and the blastocyst implants outside the womb. This abnormality is called an ectopic pregnancy, and almost 90% of the time occurs in the fallopian tubes (the pair of tubes used by the egg to travel from the ovaries to the womb). Sadly, this type of pregnancy has to be stopped, otherwise, your health could be in jeopardy.
About 1 in every 50 pregnancies in the US is an ectopic pregnancy (almost 2%), while 1 in every 90 pregnancies in the UK results in ectopic pregnancies.
What are the Signs of Ectopic Pregnancy?
An ectopic pregnancy is, after all, a pregnancy status. So, you may feel symptoms of normal pregnancy, such as nausea, breast tenderness, and of course, a missed period, and may not always cause you to be concerned. You likely will not even realize you are undergoing an ectopic pregnancy.
However, if the embryo develops in this improper place, signs and symptoms of an ectopic pregnancy may start as early as the 4th week of pregnancy. These early signs are:
- pelvic pain/lower abdominal pain
- vaginal bleeding
If the ectopic pregnancy continues to grow you may feel:
- more profound pelvic pain/stomach pain (often on one side)
If the fallopian tube ruptures:
- severe bleeding
- shoulder pain
- sudden sharp lower abdomen pain
- rectal pain or pressure
- drop in blood pressure (hypotension)
- pale skin
If you experience any unusual signs, pain, or have doubts about your symptoms, please do not hesitate to call your doctor or seek emergency medical services.
Why are the Risks of Ectopic Pregnancy Higher for Women with PCOS?
Polycystic ovary syndrome, known as PCOS, is a hormonal disorder that occurs in women of all ages. In the U.S., PCOS affects almost 1 in 10 women, and its implications go from acne and hirsutism (too much hair, commonly on the face and back) to irregular menstrual cycle and metabolic disorders like type 2 diabetes. Women with PCOS show higher levels of androgens (usually known as male hormones, like testosterone) and insulin, which leads to metabolic disorders.
Since women with PCOS have a hormonal imbalance, getting pregnant could be difficult… but not impossible!
However, you should know PCOS is linked with a higher risk of ectopic pregnancy and miscarriage due to excess testosterone and insulin. The hormonal imbalance impacts not just your menstrual cycle but also your egg quality and womb environment, tripling the likelihood of experiencing a miscarriage or ectopic pregnancy.
Talk to your doctor about it, there are several options to improve your health and reduce the risks of negative pregnancy outcomes.
How do You Treat Ectopic Pregnancies?
As we discussed before, an ectopic pregnancy must end since is impossible to “move” the embryo into the womb.
Nowadays, there are two ways of treating ectopic pregnancy: medication or surgery. Depending on your symptoms and how far along you are in the pregnancy.
If an ectopic pregnancy is detected early enough, your doctor may suggest the administration of methotrexate. This drug stops embryo cells from growing, ending the pregnancy. Your body will be able to absorb the pregnancy in about 4-6 weeks. After a few days, the doctor will repeat blood hCG levels to test if the medication has been effective. You must follow the doctor’s directions and should understand there are likely to be side effects with this treatment such as: nausea and dizziness. Almost 90% of ectopic pregnancies are successfully treated with methotrexate.
Surgical methods -both laparoscopic and laparotomy- are needed when the pregnancy is more developed and/or there are signs of fallopian tube rupture. Depending on the amount of the scar tissue and your physical condition, the doctor will decide which type of surgery is best to perform. No matter which you experience, you could experience pain or infection at the surgical site postoperatively.
Sometimes -rarely- no treatment is performed. This is called “wait and watch” and implies the natural miscarriage of the ectopic pregnancy. Nevertheless, you should always consult a healthcare provider to know all your options.
How Can You be Proactive in Your Care?
At present, the causes that lead to ectopic pregnancy are barely known. Any woman can have an ectopic pregnancy. Fortunately, you can reduce risks by taking some precautions. There are things you can do to decrease your risks such as:
Stop Smoking: The toxins in the cigarettes alter the environment of the fallopian tubes, decreasing you and your partner’s fertility and increasing risks of negative pregnancy outcomes, such as an ectopic pregnancy. So if you or your partner smoke, drop it.
Practice Safe Intercourse: Some bacterial infections, like Chlamydia trachomatis, increase the risk of ectopic pregnancy by 3 times due to the inflammation and damage of the reproductive tract tissue. So talk with your doctor about checking for infections before conceiving.
Advanced Maternal Age: Even though there is a lot of information regarding maternal age and pregnancy, you should know there is an accumulation of risk factors over time. You should discuss this with your doctor if you are older than 35 years old.
Know Your Personal and Family Medical History: Medical conditions and family history are some of the most valuable information when it come to pregnancy outcomes. It helps us to know -and many times how to prevent- and be prepared for what could happen. Surgery or birth defects impacting the reproductive (or digestive) tract, such as endometriosis, fertility issues requiring reproductive assistance, or a history of ectopic pregnancy, significantly raise the risk of experiencing ectopic pregnancy in the future. Healthcare providers are particularly attentive to these potential factors and will be more alert to potential issues in your pregnancy.
I know that some of these points are impossible to change, but knowing them gives you the power to make the better choices for you and your future pregnancy.
Should I Try to Get Pregnant Again After an Ectopic Pregnancy?
You have a 10-20% chances to repeat history, but by being informed, you can reduce these chances even more! So go for it… But before you face another pregnancy, realize that an ectopic pregnancy involves a pregnancy loss with complex emotions. You should prioritize taking care of your body and your mind. Usually, if you take medication to treat ectopic pregnancy, you will have to wait nearly three months before trying to get pregnant again. This is because of the residual effect of the drug on your body and the possible toxicity for the baby.
My Advice? Take this time to heal, and do not underestimate the emotional effect of this experience. If you feel overwhelmed, anxious, or even angry, talk to your doctor about support groups, a mental health counselor, and share your experience with your family and friends. Take your time to grieve.
What Other Ways Can PCOS Complicate Pregnancy?
As we discussed, PCOS is the most common hormonal disorder of women of reproductive age. Although there is no cure for PCOS, you can effectively manage the symptoms of this condition to increase the likelihood of a healthy pregnancy in the future, avoiding most of the common associated risks and complications.
During pregnancy, women with PCOS have an increased risk of developing gestational diabetes, pregnancy-induced hypertension, preeclampsia, long more difficult labor, preterm births, and low birth weight infants. You have to know that the odds of having PCOS and suffering some of these condition will depend on your age, medical history, ethnicity, and current health status.
You can take control by managing your weight, eating a balanced diet, regular physical activity, regular medical checks, and physiological management. These actions will improved the odds of having a healthy pregnancy and labor.
Planning and preparing for pregnancy with your provider is always the best way to ensure a safe and healthy pregnancy. You may have a health condition, like PCOS, or an obstetric record, like an ectopic pregnancy, or may both, so the best you should do is prepare!
Take the time to create a strong support network of providers – from OBGYN, midwife, mental health therapist, dietitian, family, and friends to help you make informed supported decisions for your particular situation.
Our goal, is to help you to unravel some doubts, answer common questions, translate scientific information into easy-to-understand information, and provide insights to help you make the right decisions for your life. There is hope post ectopic pregnancy and hope for a successful pregnancy with PCOS. You do have the power to change your lifestyle and do all you can to ensure a healthy and happy pregnancy.
Monica has a Ph.D. specializing in molecular and cell biology. with more than 10 years in reproductive medicine, she has now turned to medical and scientific communication through writing. She is passionate about scientific writing, and her goal is to turn the complex language of science into simple and relatable words.