Heterotopic Pregnancy Awareness

Since my near death experience, and the loss of yet another pregnancy, I have been thinking about if there is some good that could come from it all (other than the beautiful life still inside of my uterus of course). 

Although I do not know the exact answer as to why it all happened to me, and likely never will, I do know that it is now my responsibility to bring awareness to this rare, dangerous condition.  

When I first started experiencing spotting that Thursday morning, I was just 1 day short of 5 weeks pregnant. It was initially light, and mostly brown. I didnt think much of it. I chalked it up to implantation bleeding since it was so early on.  

We had just transferred two beautiful embryos 14 days prior and had received the news it worked. Our betas that week came back very high. We all (doctor included) immediately thought twins. We were thrilled. 

The spotting continued and started to turn to pink and red bleeding. By Sunday, I was experiencing sharp, shooting pains on my left side (posterior) by my hip. I called the on call service at my clinic and they set me up an appointment for Monday morning. I was sure I was miscarrying again. 

Monday morning I went in for an ultrasound. My RE was on vacation so my nurse performed the scan. I was just 5 weeks and 3 days, so there was very well a possibility of seeing nothing. But she did see one gestational and yolk sac. I was initally surprised by only one, especially with my high numbers and transferring 2. She reminded me that by next week we could see the other sac since it was so early on. The scan was over with in a few minutes, and she reassured me that bleeding early on in pregnancy is common. 

I went on my way, grateful that I had a life growing inside of me and that I hadnt miscarried. The bleeding didnt stop though. Within 2 days it was gushing out of me. I went in for a blood test to make sure my levels werent dropping. They were perfect. 

Over the next few days, I bled, passing a few clots and just feeling off. Something didnt seem right. I was 6 weeks and 2 days when things took a turn for the worse. I woke up in the middle of the night to a sharp, stabbing, shooting pain like I had never felt before. Again, it was on my left posterior side by my hip. This time though, a week later, it was much more intense. I got up, and tried to make it to the bathroom as I was seeing stars. It felt as if I had too much to drink and the room was spinning. I was either miscarrying or dying in my mind. I puked in my mouth. It was awful. 

I called the doctor (who was now back in town) the next morning. By this time, I could barely move. It felt as if I was being crushed. I couldnt even take a deep breath. She told me to come in right away. 

Immediately she saw a beating heart. I was happy but knew something still was not right. This time, instead of telling me bleeding is common early on, she started to really scan me. She was in there for about 10 minutes at least, having me move certain ways and such. 

At that point it became clear-our other embryo had implanted into my left tube. It had now ruptured and I was bleeding internally. Blood was all thoughout my stomach, up to my liver. She gave it one more day and I would have been gone. 

The point of me sharing this is to help someone out there. Not once, did anyone, myself included, consider that I could have had a tubal pregnancy until it ruptured. Especially since I had a uterine pregnancy. I do believe if the uterine pregnancy wasnt there, it would have been found sooner. All the signs of a tubal pregnancy were there but we were all blinded. 

In my case, things worked out for the best. My RE was able to remove my tube and save me and my uterine pregnancy. Had my nurse found it when my RE was out of town, I dont know how it would have played out. I know my RE is the only one I wanted operating on me, hence God works in mysterious ways. 

Heterotopic pregnancies via IVF are a 1 in 10,000 occurrence. In natural pregnancies, I believe it is even more rare, not sure of the exact number, something like 1 in 30,000. Many are under the impression that IVF cannot result in a tubal pregnancy, which is simply not the case. When an IVF transfer is done, the embryos are placed into the uterus through a catheter. Hubby & I watched this happen on the screen as little white dots. Once in the uterus, they are basically floating around, looking for a spot to implant. They can go wherever they please. 

In no way am I a doctor, but here are some signs that I feel should not be ignored or accepted as common, especially after placing 2 embryos in the uterus and getting back extremely high betas-

• Continous bleeding that starts as spotting, goes from brown to pink to red and back again 
• Sharp shooting pains in the hips on the posterior side 
• Vision obscured 
• Having difficulty breathing
• Feeling that something is just not right (listen to your body!) 

I hope I can turn our sadness to some good, and that this post can save someones life, their tube, their baby, whatever it might be.