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The structure of female reproductive organs include the ovaries, uterine tubes, uterus, and vagina. The Ovaries produce female gametes (Ova). Ovaries secrete female hormones, estrogen and progesterone. The Uterine tubes are also known as the fallopian tubes. They receive ovulated oocytes and are the site of fertilization. The Uterus’ function is to receive, retain, and nourish fertilized ovum. The vagina’s functions as a birth canal, passageway for menstrual flow, and organ of copulation. (Reproductive Unit slides 31, 33, 34, 36)

Ectopic Pregnancies occur when a fertilized egg attaches itself outside of the uterus and onto the fallopian tube. It can also attach to the ovary, cesarean section scar, cervix, or even abdomen, but the fallopian tube is most common. (Tarek Khalife, Ectopic pregnancy: Future fertility 2022) It is pretty uncommon except in patients receiving fertility treatments. The ectopic pregnancy (EP) rate among IVF pregnancies is 2.1-8.6 % after embryo transfer, compared to 2% in natural conceptions. Individuals with IUDs are at lower risk for EP than individuals who do not use contraception, however, 53% of pregnancies that occur in patients with IUDs are ectopic. (Mullany et al., Overview of ectopic pregnancy diagnosis, management, and Innovation 2023) For symptoms of ectopic pregnancies, there are no specific symptoms. Symptoms can vary from no symptoms at all in the early stage to extreme abdominal pain and dizziness from the internal bleeding. This is diagnosed when the gestational sac is found outside an empty uterine cavity. (Tarek Khalife, Ectopic pregnancy: Future fertility 2022) Treatment for ectopic pregnancy, if early on, can be medication to stop the growth of the pregnancy. If the pregnancy advances, this will present with rupture or severe bleeding and then surgery of removal of the pregnancy and control of bleeding will be initiated. (Tarek Khalife, Ectopic pregnancy: Future fertility 2022) Studies have looked at the difference in fertility after treatment of ectopic pregnancy and showed that there was no adverse fertility outcome, whether you had medical treatment with medication or surgery. Women who were treated with surgery that spared the fallopian tubes had almost the same rate of pregnancy after treatment. (Tarek Khalife, Ectopic pregnancy: Future fertility 2022) Salpingostomy and salpingectomy are the two common surgical management of EPs. Salpingostomy is part or all removal of the fallopian tube and Salpingectomy is to control bleeding levels or tubal rupture. (Mullany et al., Overview of ectopic pregnancy diagnosis, management, and Innovation 2023) Patients who undergo salpingectomy and have absent fallopian tubes will be unable to become fertile. Salpingostomy is preferred by patients who wish to retain fertility. In patients with normal contralateral fallopian tubes, salpingostomy, and salpingectomy are shown to have equivalent future pregnancy outcomes. Current literature suggests there is no difference between medical and surgical management regarding their effect on subsequent fertility. (Mullany et al., Overview of ectopic pregnancy diagnosis, management, and Innovation 2023) Innovations in surgical management of EPs may provide better future fertility outcomes. A DEMETER trial has shown that fertility rates between medical treatment and conservative surgery are not significantly different. It is emphasized that it would be more appropriate to choose conservative treatments in patients with risk factors for infertility. (Mullany et al., Overview of ectopic pregnancy diagnosis, management, and Innovation 2023) In a study conducted, in patients who underwent salpingotomy due to ectopic pregnancy, infertility was found in 21.3% and no difference was observed between salpingectomy and salpingotomy in terms of fertility outcomes. It has been found that only age affects fertility status after management of ectopic pregnancy. No statistically significant difference was found between infertile and fertile groups regarding treatment approaches. (Aysegul Bestell, The Impact of Different Management Options of Ectopic Pregnancy on Future Fertility )

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One Comment

  1. The main thing that caught my attention from this project, from what I could understand is that part of the fallopian tubes can be removed while still providing almost the same possibility of fertility. If the fallopian tubes are completely removed or absent then there will no longer be a possibility for pregnancy. I personally didn´t know much about ectopic pregnancies so this project did a great job on giving me an overview of what ectopic pregnancies are and explaining to me the different ways to treat them. This project also connected very well to the reproductive unit that we covered in class with understanding the structure and functions of the reproductive system.
    The overview I understood is that ectopic pregnancies are pregnancies that happen outside of the uterus. The egg can become fertilized in different places of the vagina like the fallopian tubes which are the most common place to see ectopic pregnancies. I found it really interesting that ectopic pregnancies can also happen on the abdomen not just in the vagina. I also understood that there is treatment available to maintain the level of fertility that an individual with an ectopic pregnancy has instead of making them completely infertile. I found the different treatments cool because it allows people to make more of a decision based on if they would like to stay fertile or not.
    The last thing that I would like to add is that the project itself is really cool. I would have never thought to make a picture completely out of candy, it looks amazing. I think the one thing I would like to learn more about is how a fertilized egg can form in the abdomen.

    Olivia Robinson

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