Effects of Endometrial Ablation on Pregnancy
Posted On: Tuesday, December 8th, 2009
Many women will have endometrial ablation and tubal ligation procedures. Although most will be satisfied with the outcomes of these procedures, some women will regret their decision and inquire about the possibilities of becoming pregnant. This article is the second in our series on endometrial ablation and pregnancy.
The first article, Pregnancy After Endometrial Ablation And Tubal Reversal, provided an introduction to endometrial ablation and introduced the possibility of pregnancy after ablation of the endometrium. This is the second article in our series and it will explain why endometrial ablations are performed and how the procedure is used to treat heavy menstrual periods.
Heavy Menstrual Periods and Endometrial Ablation
Endometrial ablation procedures are recommended for women who have anemia (low iron) from heavy menstrual periods. Most commonly women who have ablation procedures have either uterine leiomyomas (fibroids) or hormonal imbalances, which cause heavy menstrual periods.
In many instances these women have menstrual bleeding so heavy that it causes anemia or low iron. These women will have to consider hormonal treatment, endometrial ablation, or hysterectomy. Endometrial ablation provides an effective means to decrease menstrual bleeding, improve anemia, and avoid hysterectomy.
How Endometrial Ablation Works?
Endometrial ablation works by removing the endometrial layer of the uterus. The uterus can be thought of as having two layers: a thick muscular layer (myometrium) and a regenerative lining (endometrium).
The muscular myometrium provides the blood supply to the endometrium, an environment to contain and support a growing pregnancy, and muscular contractions during labor. The endometrium has the ability to regenerate, grow, and shed with every menstrual cycle. When a fertilized egg lands on the endometrium the endometrial lining will support and nurture the early pregnancy. If the endometrium does not receive an egg then the endomertial lining will shed off as a menstrual period and the cycle starts all over again.
Endometrial ablation techniques use a variety of energy sources to destroy and remove the regenerative cells which create the uterine lining. Our previous article provided a brief overview of the different types of endometrial ablation.
The energy emitted by these devices remove the endometrial layer and destroys the regenerative endometrial cells. This causes a reduction or cessation in the amount of bleeding during the menstrual period. Most endometrial ablation procedures do not remove 100% of the endometrial lining and, if regeneration of the lining occurs, then pregnancy is possible.
Risks of Endometrial Ablation
Endometrial ablation is a safe procedure that allows women to avoid removal of the uterus (hysterectomy) and the risks associated with this major procedure. No procedure is entirely without risks and the risks of ablation are:
Puncture of the uterine wall
Injury to the uterus or intestines
Pulmonary edema (fluid buildup in the lungs)
Cervical lacerations
Hematometria (blood build up in the uterus)
Pyometria (pus build up in the uterus)
Intrauterine scarring (Asherman Syndrome)
Pregnancy miscarriage, preterm delivery, and stillbirth
After Endometrial Ablation
Endometrial ablation is safe, effective, and provides high patient satisfaction rates. Despite being very effective, most endometrial ablation techniques will not remove all of the regenerative cells in the endometrium.
After endometrial ablation, most women will notice a decrease in the amount of their menstrual bleeding. Some women will continue to have menstrual periods, most women will gradually notice the resumption of menstrual periods over the next several years, and a few women will never have another menstrual period.
Although patient satisfaction rates after endometrial ablation are high, women can have menstrual bleeding return after an endometrial ablation procedure. Some of these women will need additional treatments for their menstrual bleeding.
Endometrial Ablation and Tubal Blockage
Most women will not be able to become pregnant after endometrial ablation because of tubal blockage and impaired endometrial function.
Some women will experience tubal blockage due to the destructive process of endometrial ablation. This tubal blockage will most likely occur at the area where the tube inserts into the uterine cavity. Others will have an inadequate endometrial lining after the ablation. The egg will either have no fertile endometrium to implant on or it will be insufficient to provide the early nurturing and support required by the fertilized egg.
Although endometrial ablation will reduce the menstrual periods of women, the endometrial ablation is not 100% effective at removing all of the regenerative cells of the endometrial lining.
Pregnancies do occur after endometrial ablation and women should not rely on endometrial ablation as a method of permanent birth control.
Tubal Ligation And Endometrial Ablation
It is recommended that women who have an endometrial ablation should utilize an effective and permanent birth control, such as tubal ligation or vasectomy. Women are advised not to become pregnant after the endometrial ablation because of the higher risks of miscarriage, preterm delivery, growth restriction, placental problems, and stillbirth.
Pregnancy After Endometrial Ablation
Pregnancies do occur after endometrial ablation. Our third article, Tubal Reversal, Endometrial Ablation, Pregnancy: Concerns , will explain for readers why pregnancy may be more difficult after an endometrial ablation procedure.
Readers who are interested in corrective tubal surgery or tubal reversal should visit the website of Chapel Hill Tubal Reversal Center and call (919) 968-4656 for a free tubal reversal nurse consultation.
December 8th, 2009 at 10:14 pm
[...] discussions about pregnancy after endometrial ablation and tubal reversal.The second article, Effects of Endometrial Ablation on Pregnancy, will explain how endometrial ablation decreases menstrual periods and the third article will [...]
December 8th, 2009 at 10:29 pm
This is a frequent question..’Can I have a tubal reversal and have pregnancy after an endometrial ablation?’. The information provided in these articles is excellent.
December 9th, 2009 at 11:43 am
This blog information from Dr. Monteith is always so informative and easy to understand. I hope he will continue to educate us in this way.
December 9th, 2009 at 9:14 pm
Great information. Dr. Monteith always explains things in such detail and makes it easy to understand. Wonderful article!
December 11th, 2009 at 9:13 am
Thank you for continuing to provide helpful information regarding endometrial ablation and tubal reversal.
December 12th, 2009 at 6:26 pm
What happens after 23 years of not being pregnant and all of a sudden you start looking like you are pregnant, feel pregnant, have all the symptoms of being pregnant, look pregnant, and have tingling in the fingers and in the left arm? I took a blood and urine test and it all came back negative. I don’t know what it could be. Can you give me answer on what it could be?
December 12th, 2009 at 9:06 pm
CHERY – It would be best for you to see your doctor for an examination in order to find out what is causing your signs and symptoms of pregnancy.
December 17th, 2009 at 6:46 am
[...] about pregnancy and endometrial ablation:Pregnancy After Endometrial Ablation And Tubal ReversalEffects of Endometrial Ablation on PregnancyThis article will explain the concerns and risks of pregnancy after an endometrial ablation [...]
December 17th, 2009 at 9:29 am
[...] read the preceding articles in this series:Pregnancy After Endometrial Ablation And Tubal ReversalEffects of Endometrial Ablation on PregnancyTubal Reversal, Endometrial Ablation, Pregnancy: ConcernsTubal Ligation Reversal and AblationOur [...]
December 18th, 2009 at 8:13 am
This information is very helpful. Many women are not aware of the impact of endometrial ablation on their chance of carrying a pregnancy.
December 22nd, 2009 at 2:49 pm
[...] themselves with our previous publications:Pregnancy After Endometrial Ablation And Tubal ReversalEffects on Endometrial Ablation on PregnancyTubal Reversal, Endometrial Ablation, Pregnancy: ConcernsPregnancy After Endometrial Ablation: Study [...]
January 18th, 2010 at 8:31 pm
Social comments and analytics for this post…
This post was mentioned on Digg by drchucky: Another good article in the continuation of the series on the possibility of pregnancy after endometrial ablation….
March 26th, 2011 at 6:07 pm
I had an endometrial ablasian approx. 2 years ago and have had unprotected sex with my spouse of 8 years. I never thought I could conceive. I am having symptoms of pregnancy and actually feel quickening and I have taken three separate home pregnancy tests but they were all negative. We have no family doctor as there is a shortage in our rural community and our doctor relocated to Ontario approx. one year ago. I am starting to grow concerned as I just discovered hypothyroidism and waiting too long for a hpt can result in a negative result. Any suggestions other than going to out patients? I am pretty nervous……..
March 27th, 2011 at 2:42 pm
If you have taken a good pregnancy test and it is negative then you are not pregnant.
May 20th, 2011 at 3:07 pm
im just wondering what the percentage is for a woman who have had the uteral ablation to become pregnant and how long they would have to wait..
July 7th, 2011 at 8:21 am
My question is, do women try to get pregnant after having the ablation procedure because I want to get pregnant because I had the procedure when I was married to my first husband 5 years ago. Now I am remarried and we would love to have a baby and actually are trying to get pregnant. Am I setting myself up for disappointment? I am about to be 40 years old and I feel the need to try as much as possible before we are too late!
July 7th, 2011 at 8:55 am
Some women do try to become pregnant after endometrial ablation. These pregnancies are considered high risk and are at higher risk of miscarriage, still birth, and delivery complications. WIth increasing age pregnancy also become harder to obtain. Between the ages of 40 and 43 about 30% of our patients will become pregnant, but if you have had an ablations the chance of pregnancy after age 40 and having a tubal reversal would likely be less than 30%.
November 2nd, 2011 at 5:50 am
I have just learned that I am pregnant after having a uterine ablation in July of 10′. I have taken 3 reliable urine pregnancy tests that were all negative but was still having symptoms of pregnancy. My physician did a serum HGC that was positive. I will be 43 in December and did not want anymore children. I am learning of my options at this point.
November 18th, 2011 at 10:36 pm
I had the hydrothermal ablation procedure done in August of 2010. My cycle remained fairly heavy (although not passing as many clots) and lasting 7-8 days. My ob/gyn said that my hormone levels are normal and an ultrasound did not show anything abnormal. My question is, if my flow has only slightly decreased, are the chances of becoming pregnant higher than if it had been reduced to nothing or spotting for a few days? My husband has had a vasectomy and we both would like to explore the possibility of having another child so we are considering a vas reversal. Would this be a waste of time, money, and emotion? Is the situation hopeless?
November 19th, 2011 at 10:47 am
Shannon – If hysteroscopy shows the internal lining of your uterus to be normal, then you have the chance to become pregnant after tubal reversal surgery. This is the most important test for you to have done by your local gyn doctor.
January 2nd, 2012 at 5:16 pm
I had an ablation 2 yrs ago and my tl 16 yrs ago my situation has changed and i want desperately to have my own baby.. i have seen dr’s here and they will not help me i am 42 and healthy all my levels are good .. if not for the ablation.. well if not for the ablation id be an ivf candidate
here … do you see any help for me?
January 2nd, 2012 at 5:35 pm
BethAnn – If the endometrial ablation has resulted in minimal or no periods, then pregnancy will not be possible. If you are having regular menstrual periods and hysteroscopy shows the absence of scarring inside the uterus, you would be a candidate for tubal reversal at Chapel Hill Tubal Reversal Center which has a higher pregnancy rate than IVF particularly at your age. Most IVF centers will not perform IVF on women in their forties unless they use donor eggs.