Infertility/Fertility/Pregancy after ablation and tubal
I am 37 soon to be 38 years old, a divorced mother of three. I had the ablation and tubal surgery back in 2005, which at first I did not have a period, over the years the pain and more bleeding has been substantial. Now that I have met my soul mate... I know it's so cliche, but really would like to consider having that one bond together that a child brings. Can I have a tubal reversal and what would the odds be to get pregnant and sustain the pregancy since the ablation was completed years ago, and now with each passing month my periods are actually periods with cramps?
Hello Christine from the U.S. (Iowa),
The usually answer to your question would be NO, but I think there might be a possibility in your case. There are several factors to consider, however and you need to bear these in mind as you make your decision.
1. You are 38 years old. This means that your chances for natural pregnancy is significantly lower than before. If we assume that (1) the tubes can be successfully fixed and (2) that the endometrium still forms and allows implantation, then your "natural" chance of pregnancy is 5% per month or 13% per year of trying. For comparison purposes, your chances at this age using IVF would be 50% per month attempt.
2. A tubal ligation is a procedure where a portion of the tubes is destroyed by either burning, cutting and tying, clipping or banding. The tubes then need to be microsurgically cut back to normal tube then reattached by very fine sutures. The procedure, even if accomplished, does not always lead to functioning tubes. The tube is more than just a pipe and has several different muscle layers. If it does not have each of these layers, then it will not function correctly. Also, if the tubal ligation has been over 10 years, it is unlikely that the tubes are still healthy inside and therefore, have a higher chance of failure.
3. Endometrial ablation is where the uterine lining is destroyed by burning or freezing. This then leaves scar tissue and since the lining layer has been removed, the uterus cannot form an endometrial lining and so bleeding stops. Based on the fact that you continue to have periods, that means that your ablation was probably inadequate or incomplete and there is endometrial lining developing. Therefore, there is hope that implantation can occur, but if there is extensive scar tissue, this will prevent implantation by whatever means you choose to try for pregnancy.
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com
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