I had miscarriage and ectopic pregnancy in the last six months. Is it endometriosis?

Question

Hi doctor,

I am recently trying to get pregnant and in the past six months, have had a miscarriage and an ectopic pregnancy. I am wondering if there is a chance I have endometriosis. I am wondering this because I have no other risks/causes that could have caused the ectopic. There is no chance I could have an STD because my husband and I both waited until after we were married. I am young, just 29. I have never smoked, had an abortion, had fertility treatments, or have had surgery. I also do not have an IUD.

Do you think the chance I may have it is big enough that it should be brought up with my gynecologist? I forgot to mention I have had one successful pregnancy two years ago. Also, I recently had a Pap smear two months ago and everything was normal. I have never had a bad result from a Pap smear. When it comes to symptoms, it is tricky because I feel they are very similar to menstrual cycle symptoms. I do have painful cramps on the heaviest day of my period. The cramps last for a couple of days. I have bad mood swings and bloating.I do have painful intercourse more recently. It always hurt occasionally in the past, but recently it is much worse. I also have spotting right before my period and right after.

Answer 1

Hi,

Welcome to icliniq.com.

From your history, the only problem I feel is the problem which could happen to the tube. Your history of having a tubal pregnancy and severe pain during sex, that is dyspareunia, means that there is some problem which is happening around the uterus and the tubes. So, it could be endometriosis or could be a pelvic inflammatory disease. It need not always be an STD (sexually transmitted disease), it can be common pelvic inflammatory diseases (PID) too. You definitely have a good chance to get pregnant, keeping in mind your previous pregnancy and history of tubal pregnancy. If I may suggest:

Meet an obstetrician. You will need an examination, look for any PID, you and your partner will need a good course of antibiotics.
A pelvic scan to rule out any other problems like endometriosis or an ovarian cyst.
Evaluation of the fallopian tube by HSG (X-ray with dye)/SSG (scan with dye)/laparoscopy. If any block is found, it has to be cleared.

I would give more chances for infection. Infection can cause the embryo to get stuck in the tube (ectopic), unhealthy implementation in uterus and miscarriage and also severe pain during sex. Also, it is associated with vaginal discharge and itching after sex and around periods.

Hope I have clarified your query.