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Effects of Endometrial Ablation on Pregnancy

A pregnancy after ablation needs a healthy endometriumMany 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).

A healthy endometrial layer is required for pregnancyThe 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

Balloon ablation is one type of endometrial ablation procedureEndometrial 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.

Ablation of endometrium makes implantation difficultAlthough 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 A Personal Choice and call (919) 968-4656 to speak with a staff member and have your questions answered.

Need More Information About Tubal Reversal?

A Personal Choice Tubal Reversal Center is in Raleigh, North Carolina and specializes in tubal ligation, Essure, and vasectomy reversal surgery.

Dr. Monteith specializes in helping couples have more beautiful children with reversal surgery and helping women treat abnormal symptoms after their tubes have been tied!

If you would like more information about reversal, including the cost and success rates, then enter your email address below and you will be emailed more information about reversal.

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By joining the group you can communicate with other women who have had successfully reversed their tubal ligation and restored their natural fertility.

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75 Comments

Deirdre Coleman Reply

I had an ablation in 2016. I had my tubes tied in 3008. If I get a tubal reversal, will I be able to get pregnant and have a healthy baby?


    Dr. Monteith Reply

    Deirdre
    In general it is recommended that you do not become pregnant after having an ablation procedure.

    Tubal reversal and pregnancy are possible if you are having regular periods of at least 3 days duration after your ablation. All pregnancies after ablation are considered high risk. Most IVF doctors will recommend using a gestational surrogate. IVF costs average $14,000 and you will have to pay the surrogate even more.

    If you are not having periods then we would not consider you a candidate for reversal. There is no medical treatment to make your periods return.

    Ablation will decrease the chance of pregnancy because it permanently damages the lining and muscle of the uterus.

    If your periods are light then you do have some functioning endometriumm but we are not always certain if it is enough to allow for pregnancy. There is no accurate way to be certain.

    We cannot provide an accurate percentage about the success of women getting pregnant after reversal with a prior ablation because there are no large scale studies looking at this. We have had women become pregnant naturally after tubal reversal with a prior ablation but don’t have a large enough group of these patients to provide meaningful statistics.

    You can see our patients who have had pregnancy success after endometrial ablation here: Ablation pregnancies

    Studies looking at women who have become pregnant after ablation show that about 50% will miscarry and about 50% will have live born babies.

    You should read these six articles I wrote about ablation, reversal, and the risks of pregnancy: Tubal Reversal and Ablation

    The ablation will decrease the chances of pregnancy but if you are having regular monthly periods of at least three days duration then pregnancy is certainly possible. If you are not having regular periods then I would advise against a reversal because pregnancy is not likely.

    In general pregnancy is not recommended after ablation because each pregnancy is at higher risk; miscarriage, growth restriction, early delivery, c-section and adherent placenta. The literature suggests pregnancies are at higher risk but many will do well.

    It is possible to become pregnant after having an endometrial ablation and then a tubal reversal and have a healthy pregnancy if you are having regular periods of at least three days duration every month. Please call us at (919) 977-5050 if you have any additional questions about tubal reversal.

    To be considered a candidate by our office you need to be having regular periods (every month) and these periods need to last for at least three days.

    All patients with ablations need a consult with me (Dr Monteith) either by phone or in person before they can schedule reversal surgery.


Dee Reply

I had an ablation in 2014. But I really want another child. Is it possible??


    Dr. Monteith Reply

    Dee
    In general it is recommended that you not become pregnant after having an ablation procedure.

    Tubal reversal and pregnancy are possible if you are having regular periods of at least 3 days duration after your ablation. All pregnancies after ablation are considered high risk. Most IVF doctors will recommend using a gestational surrogate. IVF costs average $14,000 and you will have to pay the surrogate even more.

    If you are not having periods then we would not consider you a candidate for reversal. There is no medical treatment to make your periods return.

    Ablation will decrease the chance of pregnancy because it permanently damages the lining and muscle of the uterus.

    If your periods are light then you do have some functioning endometriumm but we are not always certain if it is enough to allow for pregnancy. There is no accurate way to be certain.

    We cannot provide an accurate percentage about the success of women getting pregnant after reversal with a prior ablation because there are no large scale studies looking at this. We have had women become pregnant naturally after tubal reversal with a prior ablation but don’t have a large enough group of these patients to provide meaningful statistics.

    Studies looking at women who have become pregnant after ablation show that about 50% will miscarry and about 50% will have live born babies.

    You should read these six articles I wrote about ablation, reversal, and the risks of pregnancy: Tubal Reversal and Ablation

    The ablation will decrease the chances of pregnancy but if you are having regular monthly periods of at least three days duration then pregnancy is certainly possible. If you are not having regular periods then I would advise against a reversal because pregnancy is not likely.

    In general pregnancy is not recommended after ablation because each pregnancy is at higher risk; miscarriage, growth restriction, early delivery, c-section and adherent placenta. The literature suggest that pregnancies are high risk but many will do well. It is possible to become pregnant after tubal reversal and have a healthy pregnancy if you are having regular periods of at least three days duration every month. Please call us at (919)977-5050 if you have any additional questions about tubal reversal.

    To be considered a candidate by our office you need to be having regular periods (every month) and these periods needs to last for at least three days.

    All patients with ablations need a consult with me (Dr Monteith) either by phone or in person before they can schedule reversal surgery.

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