When can you get pregnant after an ectopic pregnancy?

From the Guidelines

It is recommended to wait at least 3 months after an ectopic pregnancy before trying to conceive again. This waiting period is crucial for allowing the body to heal completely, replenishing folate stores, and minimizing the risk of complications in future pregnancies 1. The risk for future ectopic pregnancy is increased among women who have had an ectopic pregnancy in the past, but combined hormonal contraceptives (CHCs) can protect against pregnancy in general, including ectopic gestation 1.

Key Considerations

• The waiting period allows the incision to heal properly for those who had surgical treatment for their ectopic pregnancy.
• For individuals who received methotrexate treatment, waiting is particularly important because this medication depletes folate and could harm a developing fetus if pregnancy occurs too soon.
• Reliable contraception and prenatal vitamins containing folic acid (400-800 mcg daily) are typically recommended during this waiting period.

Individual Circumstances

• The exact timing for trying to conceive again should be discussed with a healthcare provider, as individual circumstances may vary based on the treatment received, overall health, and emotional readiness.
• Most women who have had an ectopic pregnancy can go on to have normal pregnancies afterward, though there is a slightly increased risk of having another ectopic pregnancy.

General Guidance

• It is essential to follow the guidance of a healthcare provider, considering the specific details of the ectopic pregnancy and any subsequent treatment.
• Combined hormonal contraceptives can be an effective option for preventing future ectopic pregnancies, as they protect against pregnancy in general, including ectopic gestation 1.

From the Research

Getting Pregnant After an Ectopic Pregnancy

• It is possible to get pregnant after an ectopic pregnancy, but the timing and likelihood of a successful pregnancy vary depending on several factors, including the type of treatment received and the presence of any underlying fertility issues 2, 3, 4.
• Studies have shown that women who conceive after an ectopic pregnancy are at a higher risk of experiencing another ectopic pregnancy, especially if they have a history of tubal damage or infertility 5, 3.
• The risk of adverse pregnancy outcomes, such as fetal malformations, is generally low in women who have been treated with methotrexate for an ectopic pregnancy 2.
• Conservative surgical treatment, such as tubotomy, may be more effective than radical surgery, such as salpingectomy, in preserving fertility and reducing the risk of recurrent ectopic pregnancy 3.
• The timing of pregnancy after an ectopic pregnancy can impact the likelihood of a successful outcome, with some studies suggesting that getting pregnant within 6 months to 1 year after treatment may be associated with a higher chance of intrauterine pregnancy 4.

Factors Affecting Pregnancy After an Ectopic Pregnancy

• Type of treatment received: Women who receive conservative surgical treatment or methotrexate therapy may have a better chance of getting pregnant again compared to those who undergo radical surgery 2, 3.
• Presence of underlying fertility issues: Women with a history of infertility or tubal damage may be at a higher risk of experiencing another ectopic pregnancy or having difficulty getting pregnant again 5, 3.
• Timing of pregnancy: Getting pregnant within a certain timeframe after treatment may impact the likelihood of a successful outcome, with some studies suggesting that waiting too long may reduce the chances of intrauterine pregnancy 4.

Pregnancy Outcomes After an Ectopic Pregnancy

• Intrauterine pregnancy rates: Studies have reported varying rates of intrauterine pregnancy after an ectopic pregnancy, ranging from 66% to 94% 3, 4.
• Recurrent ectopic pregnancy rates: The risk of experiencing another ectopic pregnancy is generally higher in women who have had a previous ectopic pregnancy, especially if they have a history of tubal damage or infertility 5, 3.
• Adverse pregnancy outcomes: The risk of adverse pregnancy outcomes, such as fetal malformations, is generally low in women who have been treated with methotrexate for an ectopic pregnancy 2.