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SHAVED · May 2, 2006, 09:03 PM

Hi,
I would appreciate if someone has got knowledge in the above subject to give me an immediate answer.
One of my closest friends went on holidays on 28th March 2006. He stayed with his family for one month. His wife has consulted a gyaenacologist who gave her a contraceptive pill as both of them were preferring direct sex without a condom. She was taking the pills twice a week and as per him they enjoyed the sex. She started the pill on time. He came back to work on 29th April and on 1st May his wife told him that she is having stomach pain and a feeling to vomit and consulted their family doctor who gave an injection for the pain. Next day on 2nd May she was having the cramp again so she went to the doctor again and he diagnosed her and asked her to urgently to the hospital (casuality). She went to the hospital and they scanned her and told her that they have to operate her immediately as her fallopian tube is having bleeding due to ectopic pregnancy. She is operated now.
My friend is very much worried and would like to know how it happened as his wife was taking pills and how did the ovum got fertiled and reached the fallopian tube?

aqua@home · May 2, 2006, 09:28 PM

Hi, the pill is not 100% effective. That is the only reason I can think that it wouldn't have worked. As long as there was no human error or anything else like antibiotics to interfere, that only leaves the fact that the pill is not 100% reliable. The fact that it implanted in the fallopian tube, well there is usually no particular reason for that. Sometimes scarring can contribute but nothing has to be wrong for implantation in a tube to occur. I hope your friend is okay.

giggles · May 2, 2006, 09:34 PM

What stands out for me, is that this woman was only taking pills twice a week. I have never heard of this before. Usually, you take a pill every day for 21 days, with a 7 day break to have a "period".

Even using contraceptive pills is not 100% safe. There is a small margin for error, especially if the woman has an upset stomach, severe diarrhea, or is taking antibiotics or other medications. In fact, there has been some evidence that Vitamin C can affect apsorption of the pill, and it's advised not to take your vitamin supplements at the same time as your pill.

Ectopic pregnancies are more common in women who take the "mini pill" and in women who have had pelvic inflammatory disease due to the STI chlamydia. I hope your friend and his wife have been tested for STIs as they are not using condoms.

Hope this has been of some help!

SHAVED · May 2, 2006, 10:32 PM

Hi guys,
Thanks for the quick posting. I am from India and we have contraceptive pills taken twice a week. My friend's wife was taking it on Mondays and Fridays and she was keeping a calendar to mark that she has taken the pill regularly.
I think she was taking a new brand given by the Gyaenacologist which is similar to the one which is popular in India.
This lady was having cramps on legs while taking pills so the Doctor has given her another medicine to stop it. She is having Allergic Asthma and is under medication for it but no antiboitics and Vitamin C. Both of them are tested for STI and a very faithful couple.

kp2171 · May 2, 2006, 10:36 PM

Yes, the pill can prevent ovulation. Yes, it can change the cervix and uterus to help prevent pregnancy. But the pill is at best about 95% effective. Soooo... one in twenty couples using the pill for birth control end up with a pregnancy. Doesn't it seem less likely when they talk out of a hundred? One in twenty. Even women who have had tubal ligations can, and occasionally do, get pregnant.

There are reasons the pill shows increased rates of ectopic implantations. One reason why tubal pregnancies occur when taking birth control pills is that the hormones can slow the rate of egg movement through the tubes. Yeah... I know... you're not supposed to be ovulating. See point one above.

And as mentioned, other factors can contribute to problems with movement of the egg through the tubes, like PID, endometriosis, scarring...

Women who have an ectopic pregnant. Are more likely to have others. It'll be important to watch for symptoms in the future.

The short answer is that it can and does happen. Intercourse can get you pregnant, whether using protection or not. And ectopic pregnancies can occur, with greater rates among women using progesterone birth control and/or other predispositions.

SHAVED · Jun 26, 2006, 09:15 PM

Hi,
I am back with another issue regarding ectopice pregnancy. As mentioned in my previous post my friend's wife was operated and the ectopic pregnancy was removed. The fellopian tube was broken and it was cut. As per the request from the patient they blocked the other tube.
She is still under rest and she did not get her regular periods even after one month. She was having vomiting tendency and she approached the doctor again. The doctors scanned her and astonishingly noticed that she is pregnant
(normal in the uterus) which has happened at the same time of ectopic pregnancy.

What is the possibility of getting one ovum fertilized in the fellopian tube and another one getting fertilized in uterus at the same time.

aqua@home · Jun 26, 2006, 09:27 PM

Well what are the chances of twins? That is probably what happened. Two eggs were released and fertilized, but one implanted in the tube and the other in the uterus.

SHAVED · Jun 26, 2006, 10:58 PM

Hello aqua,
As per my knowledge there will be only one egg at a time which will be fertilized in the uterus and split into two in the uterus (twins) and there is no possibility for moving the fertlized ovum to the fellopian tube. Here it seems that there were two eggs (which is abnormal and what I would like to know) which fertilized almost at the same time in the tube and in the uterus.

kp2171 · Jun 27, 2006, 08:13 AM

This is called a heterotopic pregnancy. More common with women having treatments to increase the chance of conception.

Happens 1 in 30,000 naturally... so rare, but it happens.

J_9 · Jun 27, 2006, 09:42 AM

Okay, KP is correct so far, but I will go one farther. When a person becomes pregnant the egg is fertalized in the fallopian tube. At that point a hormone is released that moves the fertalized egg down the tube to the uterus where it becomes implanted for a normal pregnancy.

After fertalization the tiny mass of cells (egg, which has divided) moves through the uterine tube (fallopian tube) to the uterine cavity (uterus). The trip from the fallopian tube to the uterus takes about 3 days, and by then, the structure consists of a solid ball called a morula, of about 16 cells. The morula remains free within the uterus for about 3 days before actual implantation occurrs.

Now you are asking how she could have had an ectopic (tubal) pregnancy and a uterine pregnancy at the same time. Well, when one is pregnant with identical twins one egg is fertalized and splits into two, hence identical. Now we are talking fraternal twins. That is when 2 eggs are fertalized. These twins are no different than regular brothers or sisters, they are not identical in ANY way.

This is what happened to your friend. She had 2 fertalized eggs and one developed in the tube and the other moved to the uterus naturally.

So, there, in a nutshell, you have it thanks to my Human Anatomy and Physiology book.