Ablation is a serious gynecological procedure that has lasting effects on a woman’s ability to sustain pregnancy. Any woman considering an ablation should discuss the implications to her fertility with her doctor first. Likewise, women who have already had ablations and who desire to get pregnant need to discuss their options with their doctor.
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Ablation is a surgical procedure in which a thin layer of a woman’s uterine lining is destroyed. This is beneficial to a woman who has extremely heavy periods, as the procedure stops or significantly lightens her menstrual flow. An ablation may be used as an alternative to hysterectomy. A woman should only have this procedure after an endometrial biopsy comes back with a negative result, to rule out any other causes of abnormal bleeding.
According to the American Congress of Obstetricians and Gynecologists, or ACOG, women who desire to become pregnant at some point should not have an ablation. Pregnancy after an ablation is infrequent, and when it does occur, the pregnancy is rarely viable.
Women who wish to become pregnant may want to consider alternatives to ablation. Excessive bleeding can be caused by hormone imbalance and may be easily treated with medication, such as extra progesterone. The ACOG advises women to be patient: it can take months to see results with hormone treatment.
Research expands on the risks to the baby during pregnancy after ablation. A February 2005 “Journal of Obstetrics and Gynecology” study reported that pregnancy after ablation to result in perinatal mortality, premature birth, placental problems and malpresentation of the developing baby. According to the study, 71 percent of these pregnancies resulted in cesarean birth. An August 2003 “Obstetrics and Gynecology Survey” study found that only 17 percent of pregnancies after ablation progressed past 20 weeks gestation.
Pregnancy after ablation can have serious consequences for the mother as well. Case studies published in the October 2008 “Journal of Gynecology, Obstetrics and Biological Reproduction” tell of one woman who died of uterine rupture caused by pregnancy after ablation and another woman who required abdominal hysterectomy following placental complications resulting from pregnancy after ablation.
Because of the significant risk to both mother and baby in a pregnancy following ablation, the ACOG advises women to be sterilized at the time of their ablation procedure. Ablation makes it difficult to get pregnant, but it is not a birth control method in and of itself.