Congratulations, You’re Pregnant!

Congratulations on your positive pregnancy test! We know you have been waiting for this moment since your tubal reversal. And we share your excitement and concerns now that you are pregnant. Part of our long term follow-up care after your tubal reversal is following your early pregnancy along with you and your local physician.

Early Pregnancy Monitoring

Fertility Answers recommends monitoring your early pregnancy with quantitative serum HCG assays as soon as you miss a normal menstrual period. We will monitor you with blood work until you are far enough along to see the pregnancy on ultrasound.

This cautious monitoring is extremely important since you are at an increased risk for an ectopic or tubal pregnancy due to scar tissue from your ligation surgery that can block your tube. Blockage in your fallopian tube can inhibit the fertilized egg from travelling down the tube to the uterus for normal implantation. Once a pregnancy is confirmed to be in your uterus (and not in your tube) then we will send you to your obstetrician for routine prenatal care.

The rationale for early pregnancy monitoring is to prevent an ectopic tubal pregnancy from progressing to the point of rupturing the fallopian tube. Rupture of the fallopian tube results in internal bleeding and requires emergency surgery, often resulting in loss of the fallopian tube. In the absence of ultrasound evidence of an intrauterine pregnancy, early treatment with Methotrexate is recommended to terminate the pregnancy. After Methotrexate administration, serum HCG levels should be monitored until the HCG level returns to less than 10 mIU/dL.

Signs of Pregnancy

Pregnancy signs and symptoms differ between women and pregnancies. The most significant pregnancy sign is delayed menstruation. Some women will experience pregnancy signs within a week of conception. For others, signs or symptoms will not develop over a few weeks or may not be present at all.

Understanding pregnancy signs and symptoms is important for women who have had a tubal reversal mostly because of the increased chance of ectopic pregnancy. Below is a list of common pregnancy signs and symptoms:

• Implantation Bleeding:  Implantation bleeding is the earliest pregnancy sign. About eight days after conception the embryo implants itself into the uterine wall. Some women will experience spotting as well as some cramping.
• Delay/Difference in Menstruation:  A delayed or missed menstruation is the most common pregnancy sign leading a woman to test for pregnancy. When you become pregnant, your next period should be missed. Many women do bleed while they are pregnant, but typically the bleeding will be shorter or lighter than a normal period.
• Swollen/Tender Breasts:  Swollen or tender breasts is a pregnancy sign that may begin as early as 1-2 weeks after conception. Women may notice changes in their breasts such as tender to the touch, sore, or swollen.
• Fatigue/Tiredness:  Feeling fatigued or more tired is a pregnancy symptom that can also start as early as the first week after conception.
• Nausea/Morning Sickness:  This well-known pregnancy symptom will often show up between 2-8 weeks after conception. Some women are fortunate to not deal with morning sickness at all while others will feel nauseous through most of their pregnancy.
• Backaches:  Lower backaches may be a symptom that occurs early in pregnancy; however it is common to experience a dull backache throughout an entire pregnancy.
• Headaches:  The sudden rise of hormones in your body can cause you to have headaches early in pregnancy.
• Frequent Urination:  Around 6-8 weeks after conception, you may find yourself making a few extra trips to the bathroom.
• Darkening of the Areolas:  If you are pregnant, the skin around your nipples may get darker.Food Cravings:  While you may not have a strong desire to eat pickles and ice cream, many women will feel cravings for certain foods when they are pregnant. This can last throughout your entire pregnancy.