From the Guidelines
Uterine ablation is not recommended for women who desire future pregnancy, as it significantly reduces fertility and increases the risk of pregnancy complications. This procedure destroys or removes the endometrial lining of the uterus, making it difficult or impossible for an embryo to implant and develop 1. While ablation is primarily performed to treat heavy menstrual bleeding, it is associated with a high risk of pregnancy complications, including miscarriage, ectopic pregnancy, placenta accreta, and preterm delivery 1. Some key points to consider include:
- Uterine ablation is a minimally invasive technique that can be performed for patients with uterine fibroids associated with heavy menstrual bleeding who are refractory or intolerant to medical therapy 1
- The procedure is only indicated in patients who do not desire future pregnancy, as it is not a form of contraception and carries significant risks for pregnant women 1
- Patients should discuss their reproductive goals thoroughly with their healthcare provider before undergoing ablation, as the procedure is generally only recommended for women who have completed childbearing or are certain they don't want future pregnancies 1
From the Research
Uterine Ablation and Reproduction
- Uterine ablation is a minimally invasive surgical procedure used to treat abnormal uterine bleeding 2.
- The procedure involves the destruction of the lining of the uterus, which can reduce or stop menstrual bleeding 2.
- While uterine ablation can be an effective treatment for abnormal uterine bleeding, it is not a sterilization procedure and does not guarantee that a woman will not become pregnant 3.
Pregnancy After Uterine Ablation
- Pregnancies have been reported after uterine ablation, but the risk of complications is high 3.
- Women who become pregnant after uterine ablation are at increased risk of preterm delivery, cesarean delivery, and other complications 3.
- It is recommended that women who undergo uterine ablation use reliable contraception to prevent pregnancy 3.
Alternatives to Uterine Ablation
- Other treatment options for abnormal uterine bleeding include medical management with hormones or other medications, and surgical procedures such as hysterectomy [(4,5)].
- A levonorgestrel-releasing intrauterine device (IUD) is also a treatment option for abnormal uterine bleeding, and may be preferred by some women over uterine ablation or hysterectomy 6.
- The choice of treatment will depend on the individual woman's preferences, medical history, and other factors 6.