Monique Rainford

The following question by this reader raises a number of interesting issues.

Dear Dr. Rainford:

What can I do to prepare my body for a baby? I had an ectopic pregnancy in January 2006. I had an emergency surgery. I only have one fallopian tube left. How many children can I have with one? I am 33 years old this year. Is my 'clock' ticking?

Right now I am on the pill (Yasmin), but I want to get pregnant in a few months. I just feel within my soul that the pill caused my ectopic pregnancy even though I've been told this is not so. Can you explain to me what exactly is ectopic pregnancy, and was it my fault. What causes it? I am always thinking about the baby that I lost.

Dear Reader:

Maintaining a healthy diet and regular exercise is not only the formula for healthy living but also for preparing your body for a pregnancy. You should also take a multivitamin with at least 400mcg of folic acid as this will not only reduce your risk of nausea and vomiting in pregnancy but protect a developing baby from certain problems that may develop with the brain or spinal cord.

During normal conception, the egg is fertilised by the sperm and the fertilised egg travels through the fallopian tubes to the uterus (womb) where it implants in its lining. If the pregnancy implants in any other location, it is an ectopic pregnancy. Most ectopic pregnancies occur in a woman's fallopian tubes. Any factor which can prevent or delay the movement of the fertilised egg through the tube into the womb can lead to an ectopic pregnancy.

Infected tubes

A history of a tubal infection (pelvic inflammatory disease) is a major risk factor for this type of pregnancy. Other factors include prior surgery on the tubes, pregnancy after a tubal sterilisation procedure (commonly known in Jamaica as a 'tie-off'), smoking cigarettes, using fertility treatments and a history of an ectopic pregnancy.

Unfortunately, you have at least one risk factor for a future ectopic. Women who have had more than three children before having had an ectopic pregnancy are much more likely to get pregnant again. Without having had any children your chances are much lower.

Other factors which lower your chances are having had a tubal infection in the past, having had difficulty getting pregnancy and having only one tube as in your case.

That being said, you still have a chance of having a baby and I encourage you to continue trying. The number of children you can have depends on how successful you are in achieving a normal pregnancy. If you do get pregnant, it is very important that you see a doctor very early in the pregnancy to check if the pregnancy is in the womb. Fertility does decrease with increasing age and I would not recommend that you delay in your attempts.

Pelvic inflammatory disease (mentioned above) is an infection involving any or all of a woman's pelvic organs such as her uterus or womb, fallopian tubes and ovaries.

It most often occurs in sexually active females and in the majority of cases it is caused by chlamydia and gonorrhoea. While women on the oral contraceptive pill have a higher incidence of chlamydial infection, the pill actually protects against salpingitis (infection of the tubes). Women on the pill also have a much lower risk of an ectopic pregnancy. What you have been told about the pill is correct an what happened must be very difficult to cope with, the pill did not lead to your ectopic pregnancy.