Friday, September 18, 2009

Pregnancy after endometrial ablation?

Question:
Is there any possible way of conceiving after an endometrial ablation? Is there any way of repairing the uterine lining?

Answer:
Hello Leah from Canada,
 
If the endometrial ablation was performed correctly, which destroys and scars the endometrial lining/cavity, pregnancy is not possible. However, sometimes pregnancies occur where some area of the endometrium has not been ablated, which is an error in technique. In these cases, the patient will usually continue to have menstrual cycles. There is absolutely no way to repair the uterine lining. The only option would be to use a surrogate if pregnancy were desired and the ovaries were still functioning.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf.

16 comments:

  1. i had an endometrial ablation 18mths ago and my new partner and i are trying to conceive. my gyno said my lining has grown back to 4mm. could acupuncture and asprin help to thicken the lining?

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  2. You need to make sure that you in fact had an endometrial ablation. This is a procedure whereby the endometrial lining is burned by various methods. It destroys the lining and causes scar tissue formation. That is how it works to stop abnormal bleeding. It is NOT a procedure done on a woman who wants to preserve her fertility because it makes a woman infertile. Even if some lining were retained, the cavity would be incomplete for implantation and it is extremely rare to have a pregnancy after this procedure.

    Estrogen is the usual hormone used to thicken endometrial linings, but if there is no endometrium present, because of the ablation, then it doesn't work. Aspirin and acupuncture are used to increase blood flow for implantation.

    You need to confirm with your gynecologist that an endometrial ablation was done because if it was, and you want to have a child, then your only alternative might be using a surrogate. For that you will need to see a fertility specialist. You might want to do that anyway to get a second opinion, other than your gynecologists, and have someone to carefully review your records.

    ReplyDelete
    Replies
    1. I have had a positive pregnancy test I had the thermal choice done 10 months ago I had a really thick lining before the precedure I bleed very heavy for 8 weeks before a dr in her late 50's gave me birth control and it stopped it this new dr talk me into this procedure now 9 months later I have a positive test I feel pragnant, I did have peroids after it, one lasted 10 days two months ago and it was bad before the 8weeks of bleeding I had normal 5day ones I Didn't have edometryos, nore fibroids Just a really thick lining no cancer

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    2. I don't know if what you are saying is that a person can get pregnant after an endometrial ablation or not, but just to clarify in your case that may not be true. If you had any endometrial/uterine bleeding after the thermachoice procedure (endometrial ablation with hot water), that is an indication that the ablation was incomplete. That means that some endometrial tissue was left behind, and since it is hormonally response, you would have continued to have endometrial development and hence bleeding. In addition, its like the patch of dirt in between concrete, if there is a little patch of soil, you can get weeds or plants to grow. In your case, if there was some endometrial lining present, there certainly would be the chance of having a pregnancy. BUT, that is a mistake-error-unintended consequence and not how endometrial ablation is supposed to work. If the ablation is done correctly, then the entire endometrial cavity and endometrial lining is destroyed. This is what causes the bleeding to stop. In that case, pregnancy is NOT possible.

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  3. So there is no way to get pregnant if someone had ablation surgery??

    ReplyDelete
    Replies
    1. Pregnancy rarely occurs but there is an incidence. Usually this occurs because the ablation therapy was incomplete, meaning that a small area of normal endometrium was left behind. One can suspect this is the case because menstrual bleeding will usually occur. If the ablation was done well and the entire endometrium was destroyed, which is what an ablation does, then pregnancy is not possible using that uterus. A gestational surrogate would be required.

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  4. Since I have had the endometrial ablation in 2009 because of abnormal bleeding, is it possible to be a surrogate for my partner? Am I able to carry a baby to full term?

    ReplyDelete
    Replies
    1. Hello,

      Once you have had an endometrial ablation, you cannot be a surrogate. The ablation destroys the endometrial cavity. That is what prevents the endometrium from growing and keeps you from having a period or bleeding. It's permanent. Sorry.

      Delete
  5. After an ablation could hpt read negative even though pregnant?

    ReplyDelete
    Replies
    1. No. Ablation does not affect pregnancy tests which a measure of the pregnancy hormone produced by and given off by the pregnancy cells. Blood pregnancy tests are almost 100% sensitive in picking up this hormone.

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  6. I had an ablation and tubal ligation in Dec of 2012, and no longer have any periods. Is it possible for me to get pregnant if I have a tubal ligation reversal or do a IVF??

    ReplyDelete
    Replies
    1. You could only get pregnant if a surrogate were used. The ablation works by scarring up your endometrial cavity so implantation cannot occur. There are reported cases of pregnancy but that is because it was an incomplete ablation i.e. some endometrial tissue was left behind, which is an error on the part of the surgeon. If done correctly, no endometrial lining should be left behind, and the lining is essential for implantation and pregnancy.

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  7. I had an ablation nearly 3 years ago and although I still had a regular period every month it was very light and nothing compared to before the ablation. I haven't had a period for a while as I've had the contraception injection but that ran out at the end of may. I've had slight staining and cramps but no period. I know it can take a while for this to come out of the system and my periods to return. Do you think it would be possible for me to get pregnant and carry full term? After looking for information online I've found vitex successful for thickening the lining of the womb.

    ReplyDelete
    Replies
    1. Hello. the fact that you had bleeding after the ablation may indicate that not all the endometrium was destroyed, and therefore the procedure/treatment was incomplete or failed. If there is some normal endometrium then theoretically you could become pregnant and there have been such reports. However, I would not count on it as the damaged endometrial cavity and scar tissue formation resulting from the procedure would be an inhibiting factor. I can provide no guidance on "vitex" nor can endorse it. It is not a known medical treatment or fertility drug that I know of.

      Delete
  8. I had an Ultrasound hysterosonography recently and understand that Large uterine fibroids distort the endometrial canal but no endoluminal polyps are visualized. Will this affect me from getting pregnant?

    ReplyDelete
    Replies
    1. Yes. This can interfere with getting pregnant, most specifically with implantation. In addition, this can increase the risk of a miscarriage. It needs to be taken care of before attempting pregnant.

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