Tubal Reversal, Endometrial Ablation, Pregnancy: Concerns
Posted On: Tuesday, December 15th, 2009
Endometrial ablation is a common procedure to treat heavy menstrual periods.
It is recommended pregnancy should be prevented after endometrial ablation. As a result, many women will also have a tubal ligation procedure or their partners will have a vasectomy. Some women will come to regret their treatments and will begin to investigate the possibilities of pregnancy after an endometrial ablation procedure.
We receive frequent inquires about pregnancy after ablation and we have dedicated a blog series to endometrial ablation and pregnancy.
We have authored two previous articles about pregnancy and endometrial ablation:
This article will explain the concerns and risks of pregnancy after an endometrial ablation procedure.
Pregnancy And Endometrial Ablation: Risks
Endometrial ablation removes the endometrial lining. This lining is, in part, responsible for heavy menstrual periods. The lining is also the nurturing environment for the early-fertilized egg. When the endometrial lining is removed it increases the risk of causing female infertility (never getting pregnant) and recurrent pregnancy miscarriage (early pregnancy loss).
Endometrial Ablation and Tubal Blockage: Infertility
Endometrial ablation can cause infertility through tubal blockage. During the healing response after an endometrial ablation procedure, adhesions (scar tissue) can form within the uterus.
Ablation, Ashermans, and Tubal Blockage
When the scar tissue is extensive and forms between the walls of the uterus this is called Asherman’s Syndrome. The scarring after an endometrial ablation can also cause tubal blockage in the intramural portion of the fallopian tube (the narrow portion of the tube which travels through the wall of the uterus). This scarring and tubal blockage can be a cause of infertility after ablation.
Endometrial Ablation and Miscarriage: Infertility
Early pregnancy miscarriage and infertility can be a result of endometrial ablation. The ablation procedure removes the pregnancy supportive endometrial lining. The uterine muscle, which can also be scarred, is what remains. The uterine muscle is not as receptive or supportive to the fertilized egg as is the uterine lining and many fertilized eggs will never attach- the end result is very early pregnancy miscarriage –or chemical pregnancies.
If the fertilized egg should attach to the uterine muscle after the protective uterine lining has been removed then this increases the chance the early placenta will invade and grow abnormally deep into the uterine muscle.
This could cause later pregnancy miscarriage or, more concerning, abnormal placental attachment.
Without the soft, protective uterine lining, the early placenta could grow deep into the muscle. This deep placental growth into the uterine muscle is abnormal and causes the placenta to be extremely adherent. When the placental tissue grows into the uterine muscle this is an abnormal condition termed a placenta accreta.
A placenta accreta is a high-risk pregnancy condition, which could cause abnormal blood supply for the baby, fetal growth restriction (small baby), and the placenta may not detach from the uterine muscle after birth. When the placenta does not detach this increases the risk of heavy post partum bleeding, blood transfusion, and emergent hysterectomy (removal of the uterus).
Pregnancy After Ablation: How does pregnancy happen?
The goal of endometrial ablation is to treat heavy menstrual periods. Uterine ablations are effective; however, many women will have their bleeding resume and some will need additional or alternative procedures to decrease their menstrual periods. The same reason most women will have recurrence of bleeding after endometrial ablation is the same reason why women can become pregnant after a endometrial ablation. The lining is not effectively removed and may also grow back.
Pregnancies occur after endometrial ablation because of one reason: most endometrial ablation procedures are not 100% effective at removing the entire endometrial lining. Some women will become pregnant after ablation when the fertilized egg finds a soft patch of endometrium.
Studies on Pregnancy After Endometrial Ablation
The tubal reversal experts of Chapel Hill Tubal Reversal Center are dedicated to providing more information on pregnancy alternatives after tubal ligaiton procedures. For our next article, Pregnancy After Endometrial Ablation: Study Review, we will review the most recent publications in the medical literature that describe pregnancy outcomes of women who became pregnant after an endometrial ablation procedure.
August 20th, 2010 at 10:18 am
There is no way to predict the future..only time will tell. Simply removing the clamps will not make you get pregnant. Why would you have repaired the tubes and then done an endometrial ablation? We must be misunderstanding something. Did they remove the clamps and just treat the endometriosis? It does not make sense that someone would repair your tubes to get pregnant and then do a procedure which could cause future pregnancy problems.
August 20th, 2010 at 9:59 am
I am 29 yrs old. I had clamps placed on my tubes in 2008 after the birth of my third son in 2007. Since his birth and the clamps, I started noticing severe pelvic pains and extremely embarrassing, uncomfortable, heavy menstrual periods. I had a laparoscopy done this past June 2010 which showed that both my clamps had fallen off and small signs of early Endometriosis. During this procedure the doctor removed the clamps,repaired the tubes, and performed the Endometrial Ablation. I am a single mother, have never been married but hope to one day soon. I would love to share a child with my husband but am concerned due to the risk discussed in this article. I am only 2 months post-op but I am still noticing very light bleeding on schedule with my normal monthly cycle. I guess all I can do is wait and see what happens in the future, but I am interested in knowing is there anyway to determine if my cells will regenerate. Is there a way to look inside to see if I have any healthy cells left? (since the procedure is not 100% effective) Does age factor in to the regeneration of these healthy cells reproducing in the uterus?
June 22nd, 2010 at 3:38 pm
I am 40 years old. I have one natural child, age 17. I had an ablation in 2006 due to severe monthly periods that I had been getting since age 15. My periods still remained quite heavy but didn’t last as many days after the ablation. Maybe two days of heavy bleeding instead of 5. In august 2008 I became pregnant with someone I was dating at the time. At 9 weeks, the ultrasound showed a hematoma surrounding the sac. The hematoma was bigger than the sac. My specialist told me this could be catastrophic so I terminated the pregnancy.
I am now married. I tried the Nuvaring last year and had really bad edema so my husband has been looking into a vasectomy and we have been using condoms. I missed my period this week an lo and behold I am somehow pregnant. My last period was extremely heavy. My hcg levels two days ago were 786 and I will go back Thursday to see if it seems to be progressing enough to see a specialist. We are at a complete loss as to what to do as I have two kids and he doesn’t have any, but has never said he wanted any. If I decide to go through with this, I am thinking of documenting it on video and blog due to lack of information.
March 17th, 2010 at 10:23 pm
Patricia
There is no treatment for the lining to grow back. You will have to talk to you IVF specialist about the chances of a successful pregnancy.
March 17th, 2010 at 7:06 pm
i had the ablation (Novasure) three years ago, and i only had two periods last year, and i am considering ivf to get pregnant beacause my new husband do not have any children, and i also had my tubes tied nine years ago, and i want to know what are my chances of the ivf working, is there any kind of treatment for the lining of my uterus to grow back.
March 4th, 2010 at 10:14 pm
Well I had an endometrial ablation 6 years ago and I always had my period. I had my tubes tied in 99. I had a pelvic ultrasound and they found a gestational sac and they said that i was 2 weeks. We are really scared and worried that the baby will not make it. If anyone had a similar experience or can give advice it would be greatly appreciated.
February 25th, 2010 at 8:33 am
Jennifer
Pregnancy is always possible after a tubal reversal and previous endometrial ablation. We do not recommend you have a reversal unless you are having regular and predictable menstrual bleeding. Spotting once or twice would not count as regular bleeding.
February 24th, 2010 at 11:30 pm
I had a tubal litigation (rubber bands) and uterine ablation 2 1/2 years ago with no bleeding. Recently I spotted just a teeny bit and had a laparoscopy today finding out I have stage 2 endometriosis but it was in a spot my ob couldn’t get to and she drained some fluid from somewhere. I’m wanting to know if I had a tubal reversal if there’s a chance I could get pregnant. I deeply regret doing this and desperately want to experience pregnancy again. Thanks for any responses!
January 25th, 2010 at 5:02 pm
I am 34 years old and had an endometrial ablation a year and 10 months ago. I am 13 weeks pregnant and I am seeing a specialist. He does not seem to think that this will be a successful pregnancy after endometrial ablation. I was spotting with my periods with occasional heavier periods. He has told me the baby and placenta are developing just fine. Realistically, what are my odds?
January 18th, 2010 at 8:29 pm
Social comments and analytics for this post…
This post was mentioned on Digg by ChloeAOsborne: Thanks Dr. Berger and Dr. Monteith for this great information. I’m sure it will be appreciated by all patients seeking tubal reversal surgery after endometrial ablation….
January 12th, 2010 at 9:00 pm
[...] After Endometrial Ablation And Tubal ReversalEffects of Endometrial Ablation on PregnancyTubal Reversal, Endometrial Ablation, Pregnancy: ConcernsTubal Ligation Reversal and AblationOur specialty center is dedicated to corrective tubal surgery [...]
January 11th, 2010 at 11:01 pm
Cassandra
There is no medication that can cause the lining to regrow after an ablation.
January 11th, 2010 at 6:11 pm
I was told that I could take a drug that would increase the blood flow into my uterus to rebuild it. I forgot the name of it, but it was used to help a cycle start
January 5th, 2010 at 5:35 am
HOLLY – The lack of periods since your endometrial ablation means that the endometrial lining of the uterus has been destroyed, in which case becoming pregnant and carrying a pregnancy will not be possible.
January 4th, 2010 at 10:11 pm
I had the Novasure procedure 2 years ago and haven’t had a period since.I have 4 children(pre ablation) and am 35 years old and now am in a beautiful relationship and wish I could have a baby with this man. I haven’t done any type of birth control methods since the procedure.Is pregnancy probably totally out of the question?
December 22nd, 2009 at 12:21 pm
[...] After Endometrial Ablation And Tubal ReversalEffects on Endometrial Ablation on PregnancyTubal Reversal, Endometrial Ablation, Pregnancy: ConcernsPregnancy After Endometrial Ablation: Study ReviewEndometrial Ablation and Tubal Ligation Reversal: [...]
December 21st, 2009 at 5:19 pm
Very good information on endometrial ablation.
December 21st, 2009 at 4:52 pm
Thank you for this educational article. Uterine ablation is a topic that many women have questions about. And, it’s good to know that they can find answers here.
December 21st, 2009 at 3:48 pm
Roberta
I you are having periods then this suggests some of your lining has regenerated.
You could ask your doctor to perform a vaginal ultrasound to determine the thickness of your endometrial lining.
There is no way to know with certainty who will have a successful pregnancy after endometrial ablation. If you have a reversal then you will have the chance; however, you also realize that pregnancy after ablation is not without risk that we previously discussed in our article Pregnancy After Endometrial Ablation: Study Review.
December 21st, 2009 at 3:34 pm
There are many women who inquire about pregnancy after having an endometrial ablation. This article is very helpful.
December 21st, 2009 at 3:24 pm
I am a 36 year old woman who had my tubes clamped 15yrs ago and had an endometrial ablation 4 yrs ago. I am considering a reversal. I started getting a period again about a year ago they are very regular every 28 days but are light and last maybe 3 days. I only need a pantyliner for the day. Is there anyway of determining how much of my endometrial lining has come back, so I know what my chances are of getting pregnant and staying pregnant?
December 21st, 2009 at 8:50 am
The concerns of pregnancy following ablation are important for women to realize. This information is helpful to those considering pregnancy.
December 18th, 2009 at 8:46 pm
Thanks for this interesting and educational article on ablation.
December 17th, 2009 at 9:26 am
[...] After Endometrial AblationPregnancies 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 [...]