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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Not Able To Conceive,only Brown Discharge, HPT Negative. What Treatment Should I Go For?

I was supposed to get my period on March 12, but it did not arrive. All that I ve had since is a brown discharge . My husband and I have been trying to get pregnant for four years now. I don t have any other symptoms that my period is going to show up or that I am pregnant. I ve taken two HPTs and both have been negative. I also have had two ectopic pregnancies: one in 1999 and one in 2005. I have not been able to get pregnant since my last ectopic. What should I do?
Thu, 21 Mar 2013
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OBGYN 's  Response
Hello
Thank you for your query.
Firstly, with a history of two ectopic pregnancies, you have a high possibility of tubal damage, that is if the tubes havent already been removed.
If they have been removed, the only option is obviously IVF or in vitro fertilization.
If they are intact, or one is intact, you still need to consult an Infertility specialist at the earliest.
You should have complete basic hormonal assessment.
Also you should undergo a diagnostic laparoscopy to assess function of your fallopian tubes.
Your ovulation should be documented.
Husband's semen analysis should be done.
Do not wait now and consult a doctor at the earliest.
Take care.
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General & Family Physician Dr. Achuo Ascensius's  Response
Hello,
thanks for using health care magic.
Your past gyneco-obstetrical history is very relevant and could explain the reason why you have not been able to conceive recently.
If you were operated during your last two ectopic pregnancies and during each surgery the ectopic pregnancy was in a tube and it was cut out together with the tube, then your tubes are no longer patent and sperm cannot reach the egg for fertilization.
A common cause of ectopic pregnancy is a chronic infection in your pelvis which can also cause fluid or pus to accumulate in the tubes thereby preventing sperms from reaching the egg.
Given your history, these are the most likely causes that have to be ruled out before looking at other possible causes.
What you should do is to re visit the report of the management of your ectopic pregnancies and if the managment was conservative ( medical treatment or by endoscopy) you should get an ultrasoud and a hysterosalpingography tests to evaluate for chronic infection and patency of your tubes.
Best regards and hope this helps you.
Dr. Achuo
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Not Able To Conceive,only Brown Discharge, HPT Negative. What Treatment Should I Go For?

Hello Thank you for your query. Firstly, with a history of two ectopic pregnancies, you have a high possibility of tubal damage, that is if the tubes havent already been removed. If they have been removed, the only option is obviously IVF or in vitro fertilization. If they are intact, or one is intact, you still need to consult an Infertility specialist at the earliest. You should have complete basic hormonal assessment. Also you should undergo a diagnostic laparoscopy to assess function of your fallopian tubes. Your ovulation should be documented. Husband s semen analysis should be done. Do not wait now and consult a doctor at the earliest. Take care.