Just found this, and wanted to post it for future reference ( and so I can find it easily !)
Not many Doctors are in favor of conserving the tube (although from what I can gather in many cases it may be because the skill required to repair a tube far outweighs the skill required to remove it completely) I just wanted to record an argument for conserving the tube in here, so I can remember why I was so determined to keep my tube in play, even though it was the bloody awkward route to take ! Also I am trying to figure out which group of women I fall in to.....
The risk of another ectopic depends on several factors, in particular the type of surgery that has taken place, the presence of any damage to the other tube and whether there were any difficulties conceiving first time around.
Studies that compare removing the tube (salpingectomy) with opening it at the time of surgery and removing the pregnancy (salpingostomy) have found that when the other factors above have been controlled for, the risk of repeat ectopic is about 9% if the tube is removed and 12% if the tube is left behind.
There is no difference in outcome whether the operation was an open one or key-hole surgery was used (laparoscopy), but recovery is certainly quicker with the key-hole option.
So why leave the tube at all if it leads to more ectopics? The first reason is that if another ectopic were to occur and the salpingectomy had to be performed this time around, the only option for pregnancy in the future would be test-tube pregnancy (IVF). The other reason is that although the ectopic risk is slightly higher, the normal pregnancy rate may be improved if the tube is conserved.
In women who have had no difficulty getting pregnant, the normal pregnancy rate is 70% to 85% whether salpingectomy or salpingostomy was performed. For women who had difficulty conceiving the first time around, the subsequent normal pregnancy rate is around 10% if the tube was removed and 25% if it is conserved
Ok so the first factor is previous difficulties conceiving.
Both times I have been TTC I have got PG by the 3rd cycle, although I've not managed to get past 10/11 weeks with either of my pregnancies. The problem doesn't seem to be
getting PG it seems to be staying that way, or getting it in the right flipping place.
Do I fall in to the group of women who have no difficulty getting pregnancy in your opinion?
The second factor is presence of damage to the other tube
The surgeon told me that my left tube looked good, although if the EP was caused by damage to the cillia inside the tube there is no way of telling if there is a problem or not. ( That is to say everything can
look normal, but until you try and use it then there is no guarantee it is working normally) I have been told repeatedly by sonographers that there is no evidence of masses,scarring or anything overtly sinister going on.
I've never really suffered with heavy or painful periods (Irregular in my late teens yes, but not painful) I have no reason to suspect I have every had or been at risk of PCOS, Endometriosis, Fibroids or any of the other conditions that indicate a hightened risk of EP.
The other factor that is listed as affecting the outcome is type of surgery. Although the only effect this seems to have is increase the risk of infection, and require a longer recovery time. In the long run I don't think this will affect my chances of getting PG as the surgery went very well and I seem to be on the mend.
Finally, although it is not discussed in any great detail in this article, age is usually a factor for consideration. At 30 is my age likely to affect the outcome of future pregnancies ?
I'd be interested to hear your thoughts