I just read a thank-you note from a patient with a history of ectopic pregnancy who went to the emergency room after noticing mild stomach pains after another pregnancy, so the nightmare of a previous ectopic pregnancy returned. Because of the small number of days of pregnancy, the ultrasound did not accurately indicate the location of the pregnancy, but instead the mass in the adnexal region made her more restless. I thought she had a high probability of intrauterine pregnancy this time based on all the data analysis. So she was told to ignore the abdominal pain and wait quietly, and eventually time confirmed that the pregnancy was intrauterine, but unfortunately she had unintentionally taken a lot of medication during this pregnancy, which caused the baby to stop developing and miscarry. It was a scary pregnancy but not a dangerous one. It is unfortunate to have an ectopic pregnancy, although it is only one in a thousand, but once you have had it, you will never forget it, not to mention the fact that most patients have the desire to have another baby. There is no shortage of such worried patients in the clinic who are most concerned about the possibility of another ectopic pregnancy in their next pregnancy, how to avoid it, how to detect it early and how to choose the treatment for another ectopic pregnancy. I think perhaps these are the concerns of my patient and other patients who have had an ectopic pregnancy and are hoping to get pregnant. What does it mean to say that having had one ectopic pregnancy increases the risk of ectopic pregnancy in the next pregnancy by 10 times? If you were the unlucky one out of 1000 the first time, your chances of being unlucky the second time around are 1 in 100. Most patients think I’m unlucky, and I’ll tell her: the vast majority of pregnancies are actually intrauterine, aren’t they, and 99 out of 100 pregnancies will be intrauterine. So don’t be overly anxious, because stress itself increases the risk of ectopic pregnancy, so it’s crucial to relax and prepare for pregnancy. So is there a way to prevent another ectopic pregnancy from happening in the next pregnancy? The answer is: no. Can’t IVF also prevent it? The fertilized egg is placed in the uterine cavity, but the fertilized egg will wander away, so IVF does not prevent ectopic pregnancy, but even increases the risk of ectopic pregnancy. The exception to this is patients with bilateral oophorectomies, who have a very low chance of having an ectopic pregnancy when they undergo IVF. There are even all kinds of folklore, such as ultrasound monitoring of ovulation and intercourse if the ovaries are not on the side of a previous ectopic pregnancy. Although there is little data for or against this, ultrasound monitoring of ovulation is also a myth because of the wandering nature of the fertilized egg and the common history of right-sided tubal pregnancies occurring with left-sided ovulation. Other strange methods are even less scientific, such as sleeping on the healthy side of the tube after intercourse, eating more peanuts and other nonsense as a laughing matter. Some patients may ask, “Can tubal lavage or imaging before planning pregnancy after ectopic pregnancy recommended by doctors predict or prevent ectopic pregnancy? The answer is: no. The purpose of these tests is to assess the patency of the tubes after treatment. If they are not, the patient may be advised to undergo another surgery or IVF. Therefore, they are only for evaluation and not for treatment. The message that one gets from all this is that people with a history of ectopic pregnancy are at increased risk of having another pregnancy, but the majority of pregnancies are still intrauterine. There is no way to predict or prevent the occurrence of ectopic pregnancy in a second pregnancy. Therefore, it is important to relax in preparation for pregnancy and to monitor closely in early pregnancy to detect early signs of ectopic pregnancy.