An Ectopic Pregnancy: The Failure of My IUD

Welcome to my webpage. My name is Tonya and in December of 1997, I had a copper "T" Paraguard IUD inserted for birth control. This site was created shortly after my surgery for an ectopic pregnancy in November 1999. Before beginning, I want to stress that this is NOT a site that is against the intrauterine device as a choice of birth control in any way. I was extremely happy with my choice at the time to use this form of contraceptive and I enjoyed the freedom it gave me. I had no side effects from it during my use, aside for the occasional heavy period. My personal view on the matter, after having gone through my experience, is that all woman should know that this could (although it is rare) happen to them. I really want to reiterate that I am NOT against IUD use, when it's used in the proper context with women who have had children already. My intention in creating this page was to have some information out there for women who are considering an IUD, or who are having suspicious symptoms while using an IUD. Just as with the pill, condom, and diaphram, the IUD has it's good points and bad points - but in most cases, the IUD is used effectively by countless women all over the world. Again, this site is solely about MY personal experience of an ectopic pregnancy that was facilitated by copper IUD use. It is not about ectopic pregnancies in general - although it does give some symptomatic signs that may be present if you believe you are possibly suffering from an ectopic. The choice in birth control is a personal one. Women need to explore all options available in birth control, along with the pro's and con's related to the type they finally choose.

My personal story - Disbelief.

I can recall that it was a sunday night, and we were enjoying a nice dinner at the home of my in-law's. My mind though was preoccuupied with other things that evening, and I had been wondering if I should by a pregnancy test from the local drug store.

My period had always been right on time at the beginning of every month ever since the insertion of the device in December of 1997, shortly after the birth of my son. But now, for some strange reason, I was a good week or so late. I was unprepared and a little worried at the prospect of another pregnancy. I just COULDN'T be - especially since the IUD was there and had been working for two years! After all, I thought, I had spent a good deal of money on a form of birth control that was supposed to be effective for ten years! The pamphlet from the manufacturer stated that ONE PERCENT of women who use the device would become pregnant. I couldn't possibly be - the odds of it were astronomical.

I prayed that it wasn't true, but taking a home test affirmed it. Looking up IUD's and accidental pregnancies on the internet proved to be of really no help to me. Hopefully this page will help other women who find themselves in the same predicament I was in - shocked and scared - and are in need of some guidance, encouragement, and comfort. Although this page is related only to my story of IUD failure, ectopic pregnancies can also occur in instances of women with previous ectopics, women with a history of pelvic inflammatory disease (PID), sexually transmitted diseases, cysts and so forth.

Symptoms - What to look for.

1.) OK, obviously the first symptom would be failure to menstrate. If you think your late, take an at home pregnancy test ( I know this can be scary in itself, but you'll save yourself a LOT of worry time if you just go and get this over with). Now, my result came out a little odd. Looking at the stick, I couldn't tell if the result was fully positive as the line in the second window was so very very faint, I almost thought I was imagining it being there. If there is ANY sort of line at all, no matter how faint, you need to assume that this is a pregnancy. Buy a package with two tests inserted as you may be able to perform the second test a day later and get a more readable result. If there is any result other than negative, please contact a gynocologist immediately for an exam and bloodwork.

[These next symptoms are ones that I experienced AFTER affirming a positive pregnancy at my doctor's exam. Accoring to my doctor, I was five weeks in gestation when I found out about the pregnancy. I didn't have any of these following symptoms occur until a day or so after my exam.]

2.) Cramping. The INTENSE kind of cramping where you stop in the middle of whatever your doing to grab a hold of something. Also with intense cramping would be the regular "I don't feel so great" kind of cramps. A very minor bit of cramping can be felt in the first weeks of even a normal pregnancy, but this was definetly different and alarming.

3.) Fever and Chills. I walked around freezing with a blanket wrapped around me until I finally wised up and took some Tylenol.

4.) Bloated Feeling. I felt full as if I was going to menstrate but yet - nothing. No spotting, no blood, no nothing. Everything I had read about miscarriage and ectopics sited vaginal bleeding as a sign (and my clinic also had asked if I had experienced any), but this is not necessarily a symptom that will occur in every instance.

5.) Severe Lower Back Pain. By the time my fallopian tube ruptured, I had severe, mostly lower, back pain. This pain is piercing, as if your back will crack in two. I also had a bloated feeling in my lower abdomen at the same time. I felt as if my stomache suddenly looked like a small ball.

6.) Breast Tenderness. This is also something perfectly normal as a symptom of pregnancy along with a thickening waist (suddenly you can't seem to zip your pants up) affirming you that you may in fact be pregnant.

If after assessing that you may be experiencing some of the above symptoms, you'll need to be examined as soon as possible. At some point you won't be comfortable laying down, standing, sitting, or anything (and by this I don't mean - "Ugh, I feel like crap, everything hurts", but I mean a - "Something is TERRIBLY WRONG" type of uncomfortable). It is imparitive that you seek medical attention at this time.

What Happens Next.

Well, initally after finding out I was pregnant on my own during the weekend, I made an appointment the next Monday at my local clinic to get an exam. Another urine test was taken there to affirm a positive pregnancy. The first thing that had to be done was removal of the IUD. It cannot be left in the uterus as it can cause infection and also impair the fetus if, in fact, there is a healthy pregnancy. The doctor removed the IUD intact, it had not shifted or become broken. The string was still in place so this was simply a failure of the contraceptive device.

It's said that only one out of a hundred women will get pregnant using the intrauterine device. Basically, we're told that it is 99% effective at preventing pregnancy. On the other side of the coin, ectopic pregnancies are more common when an intrauterine device is used than with any other form of birth control. After it's removal, I was told by the doctor that I MAY have a chance of miscarriage due to upset in my uterus. He tried to be light about it and told me stories of other women he had treated in the same situation who had carried full term babies.

All I could think of in the back of my mind was, is this really a NORMAL pregnancy? At the time, I had remarked to the physician "How can we be sure this is a reagular pregnancy and not ectopic?" He actually looked at me kind of stunned, as if I shouldn't have known what that word means or even had the audacity to suggest such a thing. Frankly, I don't think the doctor was able to answer me on that question. When a pregnancy is early on as mine was, (I was five weeks along by their calculations, three weeks from the date of conception according to my pretty accurate memory) the doctor simply cannot see enough in utero to make a determination as to whether the pregnancy is tubal or not. The only way to know for certain would be surgery to examine the tubes. I tend to think that doctors don't want to alarm you by bringing up the ectopic scenerio, plus they may be hoping that your body will expel the tissue naturally, instead of having to resort to surgery.

A copper IUD is extremely effective at preventing pregnancy IN the womb, but, it STILL can allow a woman to ovulate and become pregnant. The fertilized egg simply finds a nice spot to implant itself, which may be in the fallopian tube or near the ovary instead. This type of pregnancy is doomed from the start as it cannot survive in the tube or be removed and surgically replanted in the womb. The doctor obliged his "nervous new mother" by giving me an ultrasound check over my belly. (Come on, I thought. Even I know your not going to see anything THIS way!) Apparently as I was only five weeks along, the doctor couldn't see any evidence of a sac. The sac is what surrounds the baby and is detectable by sonogram. No sac evident is a good sign that there is no development in the uterus. Please suggest a vaginal sonogram if your doctor hasn't performed one yet.

The next step was to perform what was called a BETA test. Blood was drawn to test hormone levels on the day after the IUD was removed, and then blood was drawn again two days later. This test checks the level of pregnancy hormone in your body. If the level goes down in those couple of days, it's likely that the pregnancy will terminate itself. If the level slowly rises, there is an indication that the pregnancy is strong. In my case, the levels did not go down, but went up like a strong, healthy pregnancy. In the four days that followed my initial exam, I had voiced concern to my clinic of the various symptoms I had been having. They, for some reason, did not bat an eye at anything I told them because I wasn't having any vaginal bleeding. I want to stress the importance here of questioning the doctor if you feel something is not quite right. "Hound" them until you find out what exactly is the matter.

Finally, on that friday, I awoke with an amazing pain in my abdomen. I made an appointment thinking that I had some sort of infection from having the IUD removed. I literally sat in the waiting room, rocking in my chair, to try and comfort myself. When the nurse called me in, I broke down in tears because of the pain I was in. The assistant couldn't even finish examining me because having someone feel around inside was agony. I was given some pain killers, taken in for a vaginal sonogram, and told to wait in a small room on a recliner until the doctor could arrive. The diagnosis after viewing the sonogram was what I had originally thought at the beginning of that week - it was ectopic. I was still stablized, but I was to have my husband pick me up and take me directly to the hospital as the tube had already ruptured and I was now bleeding internally. It would be just a matter of time before my body went into shock.

Within a few minutes, I arrived at the hospital emergency room and was sent to day surgery to be gowned and prepped for the first surgery I had ever experienced. The whole event didn't take longer than fourty five minutes, I believe. The surgeon told me she would try to save the tube if she could, but when I awoke post op, she sadly told me that it couldn't have been saved. My left ovary and fallopian tube had to be taken out along with the pregnancy, but if I wished to conceive again, I was told I would be able to as the other half of my reproductive organ was intact. I was then wheeled to my room to sleep off the medication and to be awakened several times to have my blood pressure taken, temperature taken, or blood drawn.

The incision itself is above my pubic hair line - horizontally - and can easily be covered by panties or a bathing suit bottom. It is about 3 inches in length, and my surgeon used staples to hold the scar in place. I was in the hospital overnight, and out the next day when I was able to go to the bathroom and walk around without dizziness or nausea. The area itself was tender the first few days and extra care was needed in being slow to get up out of a chair or bed, or while walking. Driving should not be done for two weeks after surgery, and you shouldn't lift anything over ten pounds for a month. The staples were removed two days after the surgery and swelling of the abdomen subsided in about a few weeks. A blood test and post-op exam was given in the meantime to check on my progress and to make sure the pregnancy was completely taken out.

I'd like to offer my help to anyone that may have questions regarding my experience or this topic. I'm not a medical professional of any sort, but if you've anything that you want to ask, or perhaps you want to voice an opinion on this site, please feel free to email.

Pandabaire@aol.com

Some Answers to Frequently Asked Questions.

"Is this procedure (the IUD inserted) 99% effective" - my opinion? Nothing is a sure thing. Since putting up this web page, I've received many letters from other women who had to endure the same ectopic situation as I did. In my estimation, the statistics that the IUD manufacturers give of a 1% failure rate is inaccurate. Reading the informational packet that is given with the device, I don't believe there is any mention of what types of pregnancies that 1% entails. The manufacturer doesn't tell you if that 1% only included women who got pregnant and had healthy pregnancies, or if ectopic pregnancies and miscarriages are included in that "99% effective" conclusion.

"When a woman has this in, can a man ejaculate inside-no condom or anything, and nothing will happen?" Again, my opinion is no. The copper IUD is effective at preventing a pregnancy from settling into the uterus and implanting, but it does NOT prevent a woman from becoming pregnant. It prevents uterine pregnancy. You can still end up with an egg being fertilized. Ectopic pregnancies are not CAUSED by IUD's, but the way the IUD works to prevent uterine pregnancy can in effect cause any fertilization that does occur to become an ectopic pregnancy.

Most months, everything is fine and no egg comes in contact with sperm. If an egg does happen to become fertilized, it will travel down the fallopian tube and come into contact with the uterus. (or sometimes it may not even leave the area of the ovary) Because the IUD is there, the copper in the device, it's believed, prevents the egg from attaching itself - copper makes a hostile environment for the egg. Medical experts aren't sure, but they believe the copper turns the uterus into an acidic environment that is not suitable for egg growth. The fertilized egg therefore does not implant and is simply passed through the system.

" Does this procedure have any effect on a woman like tenderness for a while, weight gain, changes in attitudes of way of reacting to situations? " For a copper IUD, no. Because there are no hormone additives involved, there will be no breast tenderness, no weight gain, no moodiness (except the normal PMS that comes before every period) and this in effect is why so many women turn to them. The procedure is simple, takes little time to do, and doesn't hurt much. ( While in the typical "straddle" position in the physician's office, the doctor will insert a device into the vagina to open up the entry to the cervix. The IUD is then inserted and the string pulled down into the vaginal canal. (it cannot be seen but felt) The string is for testing of the device every month after a period to make sure the IUD hasn't moved out of place and is still there)

In all honesty, I LOVED the freedom of the IUD and it's freedom from side effects such as the one's you get while on the pill. In fact, after the ectopic and surgery, I asked my doctor if I could have another one put in, but I was told because of risk to my other fallopian tube, I couldn't have one.

I'd like to mention a few other things here now that you may need to know - IUD's are normally intended for women who are in monogamous steady relationships that have HAD children already. (Any doctor who doesn't mention this to the patient is doing them a great disservice) I would highly reconsider the use of an IUD as your form of birth control if your not in this situation. I think it's ludicrous to suggest a young woman (the point being "not enough life experience") who is not married, (my point being monogomous) with no children, would be safe with an IUD inside her. The IUD can increase risk of ectopic pregnancy, therefore, putting one at risk for fertility loss in the reproductive organ. Also, when a woman has had an ectopic, she is automatically at risk for having another - therefore risking the tube and ovary she has left with subsequent pregnancies.

When I had the device put in, I had just had my son and my mid wife was the one who recommended it highly as I told her I didn't plan on having any more children. She gave me the device and informational packet for me to look over before having the procedure done. (I also had to sign an agreement to not hold the clinic responsible if anything should happen to me because of the IUD - I should've taken that as a big sign that something wasn't right) I read everything and of course thought there would be no way in hell I'd be that 1% that it talked about. Most women would have been in the same shoes as me. I thought joy of joy's!! NO HORMONES - NO REMEMBERING TO TAKE A PILL DAILY- NO WEIGHT GAIN OR ACNE!! It was the best thing to happen since sliced white bread. I spent $250 on a device that promised me no side effects and a pregnant free life for the next ten years. I only got two out of that ten for my money.

I also believe that it was definitely the IUD that put me at risk for an ectopic pregnancy as I had no other underlying conditions that could have contributed to it. No previously concluded hormonal imbalance, no congenital problems with my reproductive system, no fibroyds, tumors, or cysts - no history of PID's or sexually transmitted diseases. I was a perfectly healthy woman so the IUD had to have been the only contributing factor.

"Can a woman conceive a child after having HAD an ectopic?" Well, I'm sure this is possible and my doctor has told me that my just having one ovary and tube doesn't hurt my chances of conceiving again. I of course, haven't tried out this theory, so I cannot tell you if it's true or not. I have, since putting up this page, gotten a few letters from people who knew of cases of pregnancy after ectopic. My guess would be that it's probably easier to conceive again if the tubes aren't damaged or if one isn't removed.

For as much as I really liked the IUD, I can't in good faith tell women that they should get one UNLESS they have carefully considered it and know of the possibility of deminishing or losing their ability to have children. I think all women need to go into this procedure with the mindset that an ectopic pregnancy CAN INDEED happen to them. In my case I guess I overlooked it as I didn't plan on having more kids. A woman who intends on getting pregnant in her future should be warned by her doctor, in my opinion, of the lasting effects of risk from this form of birth control. As I said, I don't plan on having any more kids, but I guess I took for granted that I still had the ability to have more if I changed my mind. I don't think I have that luxury any longer.

WHAT TO DO IF YOU FIND YOUR PREGNANT WHILE USING AN IUD.

As I've stated earlier, after taking an at home test that comes back positive, it's necessary to make an appointment with your OBGYN. It's at this point that you can discuss your options if your worried about a possible ectopic. If after a vaginal sonogram no gestational sac is present, consider this to be a red flag that something may be wrong. Make a point of telling your doctor that you wish to terminate the pregnancy if you feel there is a chance that it's ectopic.

Option 1 - The Methotrexate Injection.

This is a solution that is injected to make your body abort pregnancy. (this is means ANY pregnancy, including a viable in womb one) As with anything, this procedure isn't always 100% effective.

Option 2 - Laparoscopic exam.

An incision is made and a scope inserted to examine the tubes to find the ectopic mass before it has a chance to rupture. Surgery can then be performed to remove the mass.

Above all, if you feel your doctor isn't doing enough for you - you don't have to put up with their lack of compassion. Please seek out a second opinion from another who has more experience with this type of pregnancy.