Pregnancy after endometrial ablation does occur. Estimates are approximately 0.7% of patients who have an endometrial ablation will accidentally become pregnant.
Some patients who have an ablation will desire pregnancy after their procedures. Many will have had a tubal ligation and will ask us about the possibility of tubal ligation reversal and the risks of pregnancy after endometrial ablation.
The tubal reversal doctors of Chapel Hill Tubal Reversal Center have dedicated this series of articles to these women seeking more information about pregnancy possibilities after ablation. This is the third article in our series on endometrial ablation, tubal reversal, and pregnancy. This article will present information from the two largest medical studies of pregnancy outcomes after endometrial ablation.
Readers are advised to read the preceding articles in this series:
Tubal Ligation Reversal and Ablation
Our specialty center is dedicated to corrective tubal surgery and tubal ligation reversal. As of 2009 we have performed over 8,000 reverse tubal ligations.
We maintain a pregnancy database and the success rates of pregnancy after tubal reversal can be as high as 90%.
Our patients come from across the United States and from other countries throughout the world. Many of these women will have unique types of tubal ligations, for example, the Uchida tubal ligation, Irving and Parkland tube tying procedures, and the Essure and Adiana tubal blockage procedures.
A few of our patients will have had endometrial ablations and will come to have tubal ligation reversal.
Pregnancy After Ablation: United Kingdom
A UK research team recently reviewed the outcomes of 70 pregnancies after endometrial ablation. In this study, 31 of the 71 pregnancies identified were live born. Of these 31 live born pregnancies, 4 infants died and 31% were born before 37 weeks. One out of four patients had very adherent placentas.
This review illustrates that pregnancy after endometrial ablation is possible, but is not without risks and complications. Although it is difficult to generalize, this study suggest about 50% of all pregnancies after endometrial ablation will make it to fetal viability (>24 weeks) and of these approximately 1 out of 3 will be born before term (37 weeks). Some infants will die as a result of premature birth and some women will have very adherent placentas.
Pregnancy After Uterine Ablation: Australia
An Australian group of researchers published a review on pregnancy after uterine ablation in 2003. This group was able to identify 43 pregnancies after uterine ablation. Of these pregnancies after uterine ablation, 17 progressed beyond 20 weeks gestation. One of the successful pregnancies was a planned pregnancy, which occurred after endometrial ablation and a tubal ligation reversal.
Tubal Reversal And Endometrial Ablation: Is Pregnancy Possible?
A tubal ligation reversal and natural pregnancy after an endometrial ablation is possible. Many women will need to be aware of the risks and complications of these pregnancies.
Since endometrial ablation was first introduced as a treatment to decrease heavy menstrual periods, medical researchers discovered and reported on some serious complications associated with pregnancy subsequent to endometrial ablation: premature birth, fetal death, abnormal placental attachment resulting in emergency hysterectomy, and some maternal deaths.
As endometrial ablation has become widely performed, the medical literature has become more balanced and has also revealed some pregnancy success stories. Overall, the risks and complications for women in pregnancy are increased after an endometrial ablation; however, the medical community still has a poor understanding of the effects of endometrial ablation upon pregnancy.
Pregnancy After Reversal And Uterine Ablation: Our Advice
The next article in our series is Endometrial Ablation and Tubal Ligation Reversal: Advice. We will offer advice on pregnancy and tubal reversal after uterine ablation. We will provide some suggestions on who may be a candidate for tubal reversal and what steps can be taken to optimize the chance for pregnancy success after an endometrial ablation procedure.
Medical Studies On Pregnancy After Endometrial Ablation
1. Pregnancy following endometrial ablation: a review article. Hare AA, Olah KS. J Obstet Gynaecol. 2005 Feb;25(2):108-14.
2. Pregnancy following endometrial ablation: case history and literature review. Cook JR, Seman EI. Obstet Gynecol Surv. 2003 Aug;58(8):551-6.