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Have No Fallopian Tubes And Have Had Successful Ivf. Getting Pain In Groin And Leg. Any Advice?

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Posted on Thu, 4 Apr 2013
Question: Hi,

I've previously had 3 ectopic pregnancies. I have no Fallopian tubes and have recently had successful ivf. I am 4 weeks and 4 days pregnant and for the last 5 days I've had severe right sided groin and leg pain. The hospital have said that its too early to feel an ectopic and are worried about ohss. They haven't offered to scan me or take a hcg test since the initial otd test which was 75. Can you help with advice?
doctor
Answered by Dr. Aarti Abraham (7 minutes later)
Hello XXXXXXX
Thank you for your query.

Firstly, congratulations on your pregnancy.
Now, prior 3 ectopics place you at a very high risk for another ectopic pregnancy, and your concerns a absolutely valid.
Pregnancy with pain in the right groin COULD indicate an ectopic pregnancy, and it is definitely not too early to feel one.
You would also have associated spotting , syncopes, that is fainting spells etc.

OHSS is another differential, that causes similar pain, but XXXXXXX , that can be easily picked up by a scan, as it would show increased free fluid in the abdomen and pelvis.

Also a B HCG value would tell you if the pregnancy is intra uterine or not, because in a viable intra uterine pregnancy, there is a specific doubling time of the B HCG , and serial values would easily differentiate an ectopic from intrauterine conception.

4 weeks plus is not too early to do either of this, definitely the scan is in order.

I would advice you to insist on one, and resolve your dilemma.
Meanwhile, please rest adequately, avoid stress, strain, avoid sexual activity and take your prescribed medications.

Wish you all the bes this time !

Please take care and feel free to ask further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (24 minutes later)
Thanks for the response. The doctor has tole me that an ectopic pregnancy after bilateral salpindectomy is possible but very rare. I'm not sure about this. What's your view on this statement? I've had 2 eggs replaced so I'm wondering is it possible that I maybe have an in uterin pregnancy and one the stump of the tube?

All my ectopics were natural pregnancies
doctor
Answered by Dr. Aarti Abraham (4 minutes later)
Your doctor is absolutely right.
An ectopic after bilateral salpingectomy is rare, but possible, so it should be ruled out.
Even rarer is the possibility of a heterotopic pregnancy, that is, one intra uterine and one ectopic.
Even that has to be ruled out.
I see no reason why a scan and B HCG should not be done.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Have No Fallopian Tubes And Have Had Successful Ivf. Getting Pain In Groin And Leg. Any Advice?

Hello XXXXXXX
Thank you for your query.

Firstly, congratulations on your pregnancy.
Now, prior 3 ectopics place you at a very high risk for another ectopic pregnancy, and your concerns a absolutely valid.
Pregnancy with pain in the right groin COULD indicate an ectopic pregnancy, and it is definitely not too early to feel one.
You would also have associated spotting , syncopes, that is fainting spells etc.

OHSS is another differential, that causes similar pain, but XXXXXXX , that can be easily picked up by a scan, as it would show increased free fluid in the abdomen and pelvis.

Also a B HCG value would tell you if the pregnancy is intra uterine or not, because in a viable intra uterine pregnancy, there is a specific doubling time of the B HCG , and serial values would easily differentiate an ectopic from intrauterine conception.

4 weeks plus is not too early to do either of this, definitely the scan is in order.

I would advice you to insist on one, and resolve your dilemma.
Meanwhile, please rest adequately, avoid stress, strain, avoid sexual activity and take your prescribed medications.

Wish you all the bes this time !

Please take care and feel free to ask further questions.