Tubal Reversal After Ablation: Pregnancy Advice
Posted On: Tuesday, December 22nd, 2009
Pregnancy is possible after tubal reversal and ablation. This article is a continuation of a series providing information about the possibility and risks of pregnancy after endometrial ablation procedures.
This article continues the advice for women who have had ablation and want to become pregnant.
The previous article, Endometrial Ablation and Tubal Ligation Reversal: Advice, offers medical advice for women who are not having menstrual periods after ablation.
This article focuses on women who have their menstrual periods persists or resume after their ablation procedures. Readers should familiarize themselves with the five previous articles:
Pregnancy After Endometrial Ablation And Tubal Reversal
Effects on Endometrial Ablation on Pregnancy
Tubal Reversal, Endometrial Ablation, Pregnancy: Concerns
Tubal Reversal and Uterine Ablation: Light or Normal Periods?
If menstrual periods are light or normal after uterine ablation, then this suggests some of the endometrial lining has either been left intact or regenerated. Tubal reversal and pregnancy could be possible.
Light or Normal Menstrual Period: Advice
Women should consult their doctor and consider having an ultrasound to evaluate their endometrial thickness and a hysteroscopy to evaluate their uterine cavity. An ultrasound can provide a quick assessment of the endometrial layer and a hysteroscopy can provide a quick assessment of both the uterine lining and the uterine cavity.
Asherman Syndrome and Scar Tissue After Ablation
Asherman’s Syndrome is a condition in which scar tissue forms between the uterine walls and compromises the cavity of the uterus.
Scar tissue in the uterine cavity can occur for many reasons, and scar tissue formation in the uterine cavity is a well-recognized complication of endometrial ablation. If scar tissue does form within the cavity of the uterus this can cause spotty or absent menstrual periods, infertility, recurrent pregnancy miscarriage, or preterm pregnancy loss.
After Ablation: Consider a Hysteroscopic Exam
Hysteroscopy is probably the single most important evaluation when considering pregnancy after endometrial ablation.
This is a procedure where the doctor inserts a narrow telescope through the cervical canal and evaluates the uterine cavity for scar tissue and the health of the endometrial lining. During this procedure, the doctor may be able to successfully remove any scar tissue.
Successful Pregnancy After Ablation?
If the uterine lining remains after an ablation and if the uterine hysteroscopy demonstrates a good uterine cavity without scar tissue, then pregnancy is always a possibility with either tubal reversal or IVF.
Readers must recognize that even if all of these factors are optimal after an ablation then no guarantees can be given about the success of any subsequent pregnancies.
Even with a normal lining after an ablation the possibility always exists of damage to the uterine muscle from the ablation. There is no medical test or x-ray, which can predict or diagnose damaged or dysfunctional uterine muscle after ablation.
Reverse Endometrial Ablation?
There is no medical treatment that can reverse the effects endometrial ablation. If menstrual periods have ceased after ablation, then very likely the endometrial lining has been entirely removed. No effective treatments exist to add or replace the lining, even if menstrual periods are scarce or light.
Any treatments to reverse the effects of endometrial ablation should be considered experimental.
Tube Reversal After Ablation
Tube reversal and pregnancy are both possible after endometrial ablation, but only if you are having menstrual periods after the ablation. IVF does not provide any additional benefit over tube reversal for women who have had endometrial ablation.
The tube reversing specialists at Chapel Hill Tubal Reversal Center advise women to have an evaluation of their uterine cavity to determine the health of their lining and to diagnoses and treat uterine scar tissue before having tubal reversal surgery. Tubal blockage as a complication of endometrial ablation can be evaluated at the time of the tube reversing surgery.
Although pregnancy is possible after ablation, the effects of endometrial ablation upon pregnancy are largely unknown. Any pregnancy after ablation should be considered high risk and followed by a high-risk pregnancy doctor. Despite all factors being optimal, no guarantees of pregnancy success can be provided.
Readers should familiarize themselves with the concerns of pregnancy after endometrial ablation and the medical studies on pregnancy outcomes after uterine ablation.
Ablation, Tubal Reversal and Fibroids
Our next and final article on tubal reversal and ablation, Endometrial Ablation, Fibroids, and Pregnancy, will share the personal reversal story of Shaunda who came to our center for reversal of Filshie clip sterilization after an endometrial ablation. Her endometrial ablation was done because of anemia due to heavy menstrual periods and uterine fibroids.
August 28th, 2010 at 8:28 am
im disappointed i didnt get my period this month i dont get it first month after my ablation i spotted 2nd month i got my period for 4 days medium flow now nothing whats wrong with this picture
July 31st, 2010 at 11:57 pm
Thank you so much I will send them first thing Monday morning because my doctor wanted to see me anyway thanks.
July 31st, 2010 at 10:35 am
Jean
I do think you would be a candidate for tubal reversal and we would love to help you. Please be aware since you have had an endometrial ablation any pregnancy after tubal reversal would be higher risk for miscarriage, preterm birth, placental problems, and difficult delivery. Please read our complete blog series on endometrial ablation and the risk of pregnancy after endometrial ablation. Please mail or fax your operative records from your tubal ligation and your endometrial ablation to my attention.
Dr. Charles W. Monteith
Chapel Hill Tubal Reversal Center
109 Conner Drive
Suite 2200
Chapel Hill, N.C., 27514
Phone (919) 968-4656
Fax (919) 967-8637
July 31st, 2010 at 9:00 am
It has been a month since I wrote last and I got my period medium flow for 3 days- so far could I almost be a possible candidate for a tubal reversal?
July 16th, 2010 at 3:45 pm
You would need to be having regular periods…spotting alone would not suffice.
July 16th, 2010 at 2:35 pm
hello its me again i just randomly started spotting and i was wondering could my period be coming back is there hope for my tubal reversal now please tell me there is
July 14th, 2010 at 9:29 pm
Thank you again for answering my questions if i ever get my periods back again i will definately come to your office for my ligation ill keep saving ill never lose hope
July 14th, 2010 at 6:45 am
Jean
Any medications to repair the uterine lining is experimental. If the lining has been destroyed by the ablation then it can not be replaced.
July 13th, 2010 at 10:55 pm
Dr. Berger thank you for answering my question. I do have one more: after my ablation is there anything I can do to repair my uterine lining like with medications like premarin or anything i can do?
July 5th, 2010 at 5:13 pm
Pregnancy after tubal reversal is always possible. However, after endometrial ablation, your periods would have to return before you could expect to get pregnant.
July 5th, 2010 at 3:17 pm
i had my tubal ligation a year ago And had an novasure ablation a month ago and my periods havent returned if i had a tubal reversal could pregnancy be possible
April 26th, 2010 at 8:04 am
Melissa
We are sorry you feel like you are in a hopeless situation. Unfortunately, we limit our practice only to tubal ligation reversal and repair of blocked fallopian tubes. I would suggest you talk with another IVF specialist who may be able to help you. There are two main risk of IVF among women with a previous endometrial ablation:
1. It may never work if there is no endometrium to support the implanted embryo.
2. You still have the risks of pregnancy after an endometrial ablation.
If you are unable to find someone to do IVF for you then you should consider a gestational surrogate. Your reproductive specialist can talk to you more about this.
April 25th, 2010 at 7:58 pm
I am 30 and had an a Novasure endometrial ablation two years ago. I have three kids from a previous marriage. I am remarried to a wonderful man and we would love to have a child that we share together. Due to my endometrial ablation, I can’t get anyone to help me with my situation. I had an appointment with an RE, but he didn’t seem interested in my case or hopeful. He hasn’t even done any tests, but seems to have absolutely no hope for my chances of conceiving. I am hoping to find a doctor, that will at least be human enough, to have some hope with me. I am healthy, I have no other medical problems, other than my ablation. I still have spotty periods every month and I ovulate. My husband is very healthy and has a ten year old daughter. I just need to know that there is hope. Thanks for your sight, I don’t need a tubal reversal, but Dr. Berger has been mentioned several times on other websites, with women who are going through the same thing I am. I wish I could meet with him, about my chances, but upon calling the facility, I was told that if I didn’t need a reversal, then I couldn’t been seen.
Thanks,
Melissa
April 3rd, 2010 at 5:46 pm
Jean – Uterine rupture is not a complication associated with pregnancy after endometrial ablation. If there are adhesions or scar formation within the uterine cavity, these can result in abnormalities to the development of a baby’s limbs.
April 2nd, 2010 at 10:15 pm
Hi. Thanks for the information on your site. It has been incredibly helpful. I am pregnant, 42 yrs old, mother of 4. I had no previous pregancy issues but had a balloon ablation to address anemia and very heavy periods (about a year ago). I continued to have periods although lighter than what they had been. Aside from the issues associated with my age, I am very concerned about the risks to me and/or the child later in preganancy. Early miscarriage – I understand the risks of insufficient lining and if it happens then the pregnancy wasn’t meant to be. The doctors have explained acreta to me and seem to think that the health risk related to that is only an issue in delivery, and that we can deal with that issue when the time comes. So its what happens in between that has me concerned. What are my risks in the second and third trimester? 1. Assuming I get to 20 weeks or so, what are the risks of premature birth or other abnormalities to the baby? 2. What are the health risks to me before labor(like could my uterus burst/bleed DURING preganancy)? Thanks.
January 12th, 2010 at 12:26 pm
Thanks for the article providing advice for women who have had endometrial ablation and want to become pregnant.
December 28th, 2009 at 1:32 am
Thank you so much for what you are doing. It has really helped me.
December 23rd, 2009 at 3:51 pm
Kathie
You are correct – there is not a lot of information for a woman who has had an ablation to determine what her individual chance is of pregnancy after endometrial abalation. I would also presume there will likely never be any seriously helpful information. Who will study this and how would such a study ever be done?
I also think it could be misleading to try and extrapolate what your risks would be based on any individual factors discussed in a case report. Any attempt to do so could be an attempt to rationalize yourself into a false sense of security. Admittedly, a large number of reported pregnancies are after balloon endometrial ablation.
If you would like more information you will probably have to go to a medical library and look up the citations for more information (unless you internet access to medical journals).
Unfortunately, the best conclusions I can come to at this time are:
1. Pregnancy is possible after ablation if you are having regular menstrual periods.
2. This risks of pregnancy after ablation are miscarriage, preterm pregnancy loss, and placental abnormalities.
3. Individuals will have to decide if they are willing to take these risks- but this same point could be made about the decision of any woman to become pregnant even in the absence of any risk factors.
December 23rd, 2009 at 3:50 pm
After all of my research, it seems that there is not enough data compiled to give me an accurate picture of my chances of success- 0.9% pregnancy rate was listed as accidental. Were most of these women using birth control as directed following the procedure? There are no measurements of the linings due to 112 out of 113 pregnancies being accidental and a percentage of those being purposefully aborted. Do you have any information on the successful planned pregnancy following ablation and tubal reversal? Was a specific report of that woman’s pregnancy, birth, complications, etc…submitted? If so, did she make it available to the public? It seems there is little information for someone in my position with which to make an informed decision. The listed risks make a huge difference in my decision but it seems my situation is very different from everyone else primarily in that my ablation was a failed procedure. I was not able to access full case studies from the links in your article on endometrial ablation, only very brief summaries that did not answer my questions. Can you help me find more detailed information with which to make an educated decision regarding my course of action, if any? Thank you for your time.
December 23rd, 2009 at 3:49 pm
Read the blog about studies of pregnancy after endometrial ablation. We will be publishing more blogs about pregnancy after tubal reversal and endometrial ablation.
December 23rd, 2009 at 3:46 pm
I am 38. Had one miscarriage at age 18, 2 children full term healthy vaginal deliveries in 92 and 94. tubal in 94 using rings only. endometrial ablation in 06 using hot water no balloon. My bleeding is only slightly reduced but still heavy and resumed immediately following the procedure. i am overweight, a non-smoker, and have no health problems. i have had a saline infused ultrasound which shows the lining of my uterus to be in a healthy state and actually a little thicker than normal. All this seems like my chances of pregnancy may be pretty good following a reversal. i know the ablation procedure is still very new. Can you tell me if there are any statistics available that can tell me what my chances of a healthy pregnancy might be if i do have a reversal?
December 23rd, 2009 at 6:56 am
Good to know that there are also positive aspects to ablation. Thank you for the article.
December 22nd, 2009 at 6:05 pm
Thank you for more great information regarding pregnancy and endometrial ablation.
December 22nd, 2009 at 5:54 pm
Thank you for offering the positive and negative aspects of endometrial ablation. Women considering tubal reversal should go into this with their eyes wide open.
December 22nd, 2009 at 2:49 pm
[...] Reversal After Ablation: AdviceWe will continue our advice in the next article. The next article, Tubal Reversal After Ablation: Pregnancy Advice, will focus on patients who have light or normal menstrual periods after endometrial ablation.More [...]