A Personal Choice A Personal Choice BBB

Pregnancy After Endometrial Ablation And Tubal Reversal

Endometrial ablation removes the endometrial liningMany women will have both a tubal ligation and an endometrial ablation procedure. Some of these women will regret their decision and wish to become pregnant. We have frequent inquires about the possibility of pregnancy after an endometrial ablation procedure.

A successful pregnancy is possible after an endometrial ablation; however, there are unique risks of pregnancy in women who become pregnant after ablation. Women who are considering pregnancy after an endometrial ablation need to be carefully informed about these risks. The tubal reversal experts of A Personal Choice would like to provide readers with more information about endometrial ablation, tubal reversal, and the risks of pregnancy after endometrial ablation. This is the first article in our series about endometrial ablation, tubal reversal, and pregnancy.

Endometrial And Uterine Ablation: Treat Menstrual Periods

Uterine ablation is an incorrect term. Often this term is used when people refer to an endometrial ablation. Occasionally, people will also confuse uterine ablation with an entirely different surgical procedure called a uterine artery embolization (UAE). Uterine ablation is inaccurate terminology and many women will have either a uterine artery embolization (uterine artery blockage) or an endometrial ablation (uterine lining removal) for treatment of heavy menstrual periods.

Uterine artery embolization blocks the uterine arteriesBoth uterine artery embolization and endometrial ablation are procedures to treat  heavy menstrual periods. Although they both decrease bleeding, each procedure is uniquely different.

The uterine artery embolization is done by a radiologist in a radiology procedure room and involves blocking the uterine arteries to decrease blood flow to the uterus and decrease blood loss during the menstrual period.

An endometrial ablation is a surgical procedure done by a gynecologist either in the office or the operating room and involves removing the endometrial lining of the uterus. This also helps to treat anemia by reducing or eliminating blood loss during menstrual periods.

Both of the above procedures are designed to treat anemia and heavy menstrual bleeding. They each do this through a different process and pregnancy is possible after either endometrial ablation or uterine artery embolization. The purpose of this series of articles is to explain the risks of pregnancy after endometrial ablation.

Pregnancy And Endometrial Ablation Procedure

The goal of the endometrial ablation is to permanently remove the endometrial cells that make up the lining of the uterus. There are many different types of ablation procedures:

Laser ablation
Roller ball electrocoagulation
Transcervical resection (actual removal of the lining)
Cryoablation – Freezing. (Her Option)
Thermal ablation -hot water balloon (Thermachoice)
Thermal ablation -hot water (HTA)
Microwave endometrial ablation (FemWave)
Electrocoagulation (Novasure)

Although there are many different  endometrial ablation techniques, these procedures are all intended to have the same end result: removal of the endometrial lining and a reduction in the amount of bleeding during a menstrual period.

Menstrual Period And Endometrial Ablation

Most endometrial ablations are not very effective and will not remove 100% of the uterine lining. A significant number of women will continue to have menstrual periods immediately after or within five years of an endometrial ablation procedure. These are the women who are most likely to be able to become pregnant.

Endometrial Ablation: Tubal Ligation or Vasectomy?

Pregnancy is possible after an endometrial ablation procedure, and, because of the possibility of pregnancy, most doctors recommend a permanent form of birth control in women who undergo ablation procedures. The most common procedures during or after an endometrial ablation are vasectomy or tubal ligation. Some women who undergo endometrial ablations will use a hormonal form of contraception or rely on the protection sometimes afforded by older age.

Menstrual Period After Endometrial Ablation

Women who have a menstrual period after an endometrial ablation can become pregnant and pregnancies after ablation have been reported in the medical literature.

Pregnancy after ablation and tubal reversal are possibleSome women will accidentally become pregnant after an endometrial ablation. The majority of these pregnancies have been among women who were not using birth control or not using a reliable form of birth control or among those who have had a failed tubal ligation or vasectomy. Some pregnancies have been among women who have intentionally had either IVF or tubal ligation reversal.

Pregnancy is most likely to occur in women who have resumption in their normal menstrual cycles because these are the women who still have enough lining to create a menstrual period and support a pregnancy.

Endometrial Ablation And Tubal Reversal: Is Pregnancy Possible?

Many women will regret their decision to have a tubal ligation and endometrial ablation and will inquire about reversal. Most manufacturers of endometrial ablation devices and most physicians who perform endometrial ablations do not recommend becoming pregnant after an ablation procedure. Pregnancy is not recommended because of the higher risk of miscarriage and pregnancy loss.

Pregnancy after endometrial ablation and tubal reversal is possible but there are unique considerations regarding pregnancy after an endometrial ablation.

The second article, Effects of Endometrial Ablation on Pregnancy, will explain how endometrial ablation decreases menstrual periods and the third article will present information about the risks of pregnancy after endometrial ablation.

567 thoughts on “Pregnancy After Endometrial Ablation And Tubal Reversal”

  1. Elizabeth says:

    I’m 33 years old, had my tubes tied 12 years ago. A ovary removed 11 years ago. And a endometrial ablation in April of this year. I just recently meet a great man. But he wants to have more kids, what are my chances of having a successful pregnancy if I got my tubes reversed. And would I even be a candidate??

    1. Dr. Monteith says:

      Elizabeth
      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.

  2. Morgan says:

    I had my tubes tied in October of 2005 and anovasure procedure done in April for extreme heavy bleeding and hormone issues. I have never missed a period since the time of surgery and they last an average of 6 to 8 days and bleeding has gradually increased back to that of almost a normal period prior to my tubal. I am 41 years in age and have had 3 extremely healthy pregnancies carrying all 3 days to term. I am wanting to have one more child. Is this even a possibility with the combination of age and procedures that I have had?

    1. Dr. Monteith says:

      Morgan
      Pregnancy is possible but you certainly have many factors against you.

      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.

Leave a Reply

Leave the name blank if you wish to remain anonymous. Your email address will not be published.