Posted by: emenems

To whom it may concern:

In 2014. I had an extrauterine pregnancy in left Fallopian tube, which was treated with methotrexate. The tube was preserved. Since then, I didn’t try for pregnancy until 8 month ago. Now I am trying to conceive, and I notice a one-day light vaginal discharge (fresh blood), when the ovulation is on the left ovary. Is it about sudden decline in estrogen level, or is about the ovary and the tube?

Would you recommend a blood draw for hormones, cervical swabs or any other tests?

Do you recommend a diagnostic laparoscopy to evaluate a real condition of the Fallopian tubes? Thank you for your answer.

Answer by: Romana Dmitrovic, MD, PhD

Bleeding during ovulation is not uncommon, so if the ultrasound exam is normal, blood sample for sex hormone level will not help. On contrary, inability to conceive and previous extrauterine pregnancy, provides more information. Extrauterine pregnancy is a proof that one of your Fallopian tubes at the time was not functional.  Also there is a possibility that the other one is damaged, which could be the reason you cannot conceive.

Although you did not mention some relevant information (as your age), if tubal changes are not visualized on ultrasound, I do not recommend diagnostic laparoscopy as it is invasive procedure with possible serious risks.  If a woman did not conceive during one year of unprotected intercourse, we presume that her tubes may be damaged. So, I recommend that you wait until then, when you will be a candidate for assisted reproduction.

Sincerely,

Romana Dmitrovic