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.

31 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.

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    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??

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    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?

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    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.

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

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    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??

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    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.

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    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.

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  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?

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    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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  9. I am 38 and had an tubal were they burned a section of tubes in 2004 then had a uterine ablation in 2011 and my husband to be wants a child and i would love to have one i was woundering if its possible to have mini ivf i have three kids now ages 13,12,11 and what are the steps to take and how much i was having regular perods after the abltion started last january 2014 then last december 2014 i had 3 days of light brown discharge as this month dont no why please help me with some answers thanks

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    Replies
    1. Hello. If it were only a tubal ligation, IVF would be an option, but having had an endometrial ablation takes that option away. You need a normal uterine cavity and endometrial lining to achieve rpregnancy and I'm afraid that the ablation took that away. That's how it works. Your only option would be IVF to use your own eggs and then use a surrogate for implantation and pregnancy.

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  10. I have had irregular period all my life. I recently found out that my hormones where out of control. Estrogen dominance. I've been wanting to conceive even though I had my tubes tide 6 years ago at the age of 25. Was wanting to get a tubal reversal. That was my plan, but this dreams was crushed when on April 28 I when under surgery for a scheduled D&C to control my mensuration. When I woke up surgery my doctor told me she made a mistake did an ablation me. I was shocked and in pain from the procedure, did not even consent to have this done on me. She (my doc) was like "Oops, I'm sorry." It was a heart breaker for me!

    I know this is a dumb question but is there any hope for me to ever become pregnant after a tubal and an ablation? I did get my period just a month after the procedure. At least that's a hopeful sign. I'm 31 years old and on natural progesterone cream to balance my hormones.

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    Replies
    1. I would have to advise that, although I am a believer in miracles, it is highly unlikely that you will be able to achieve a pregnancy without using IVF and a surrogate.

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  11. I had an ablation in 2005 and my periods got a little bit lighter. I still have my periods for 3-4 days every month and the usual PMS and cramping. I am going to Shady Grove tomorrow to see if they will do IVF. What are your thoughts?

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    Replies
    1. Hello Brandi,

      Ordinarily, an endometrial ablation permanently destroys the endometrial cavity and so using your own uterus is not possible. However, if the ablation was not done completely there is the possibility of implantation at the site of normal tissue. Considering that you have continued to have regular cycles is an indication that you probably have a site that is still normal and was left un-ablated. Although there is a chance that you could get pregnant if the embryo lands at that site, I would rate it unlikely. I can't give any percentage because I don't think there is IVF data with that specific situation. Shady Grove, or any other IVF center, might be reluctant to do a procedure in your case, but they would probably want to look with a laparoscope to see what the cavity looks like to make their final decision. Of course, it is your money and ultimately your decision, but we would generally advise against it because there would be so much scar tissue within the cavity rendering the cavity unhealthy and the chances slim.

      Good Luck

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  12. Hi, I had a novasure ablation 5 years ago at 36 years and have been having cyclic pain/cramping with a period smelling clear discharge. I had an ultrasound on day 1 or 2 of my cycle showing 4.4mm endometrial lining with streaks radiating from there under the scar tissue into the myometrium. Can my scar tissue be cleaned out so that there is space for the period to exit through my uterine cavity and not push into my uterine wall - I'm looking for pain relief and some kind of normal period instead of this trapped stuff.
    Drs quickly recommend just hysterectomy but I want to avoid this because of structural issues, possible sexual dysfunction and potential abdominal adhesions (have had in the past after c-section).
    Is there any hope of clearing out the uterine cavity for some kind of release? Thanks.

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    Replies
    1. Yes. It can be done by doing a D&C (Dilation and Curettage) or by operative hysteroscopy. Sometimes, after ablation, the cervical canal will be scarred as well so a Dilation of the cervix will open the pathway for the discharge to exit.

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  15. I had my tubes tied in 2012 after my daughter was born and then the novasure done in 2013. My husband and I want to have another baby and can I still have egg retrieval done and use surrogate ?

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  16. Hello, I had a bilateral tubal ligation done in April 2009, later in March of 2012 I had a Endometrial Ablation VIA Thermochoice. Last week I had a Pelvic ultrasound done and it shows my Endometrial Stripe is 4mm but is NOT thickened. do you think I Can still have a healthy Pregnancy after tubal reversal or If I can become pregnant at all?? Please HELP. Thanks oh and I have a period every month that's normally last for about 5 Days

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  17. I had a tubal 5 year ago and an ablation von 02/24/17 it did not work the bleeding return in less than 1 month and has been since. My husband and I want to try to have another child is it possible? Also could have multiple Chemical pregnancy because the bleeding happens at different times?

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  18. I had a doctor tell me that just because I had a novasure done and my tubes tied I could still get pregnant... I had 3 c-sections after my 3rd one the same doctor said I had no scar tissue from the first two. My friend asked me about surrgusy I told her I would look in to it. If there was a shred of hope I would do it in a heart beat. So is there any way? We can at least try and talk to a doctor.

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  19. In 2007 right after my c-section with my son, I had my tubes clipped, tied and burnt. Then in 2009 I had a benign tumor on my left ovary which resulted in the lose of my left ovary and fallopian tube. Then in October of 2018 I had the procedure called ablation done. In this case it does not show any signs that it was ever done, as I still have heavy periods, possibly even heavier then before. Before the ablation my gyno said that I still had a uterus of a young girl at the age of 34. So my question is.... is it possible that I can have my tubes reversed and possibly still bare a child?

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