Why does an ectopic pregnancy occur? For simplicity, I am restricting myself to those that occur in the fallopian tubes. Tubes are delicate structures and any infection or inflammation can cause injury leading to partial or complete block of the tube. The mucosa or the inside skin of the tube may become damaged leading to the dysfunctional movement of a newly formed embryo towards the uterus. The embryo therefore may get stuck and start growing in the tube itself. In many women, it may be impossible to identify the episode/cause of the damage.
For someone who has had an ectopic pregnancy in the past, what are the implications? Women who have an ectopic pregnancy are at risk of another ectopic pregnancy. This happens because, the event/agent that caused injury or damage to one tube may well have affected the other tube. It is not uncommon to conceive spontaneously and have uneventful normal pregnancy (and delivery) after an ectopic pregnancy. However, a delay in conceiving should be managed appropriately. Depending on the clinical circumstances, IVF may be recommended. Even if Intrauterine insemination is attempted, the trial of this treatment should be short with the escalation to IVF. This will avoid the additional implications of declining egg quality with age. A short-sighted approach of low-cost treatments for too long may otherwise be a disservice to the couple involved.