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Infertility/Fertility/Pregnancy after ablation done 2 years ago

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A year ago last July I had an ablation done to stop heavy non stop bleeding. For 18 months I tried everything in the book to stop the bleeding( several pills, an arm implant, etc.), my doctor had me try several different options to avoid surgery. I am 29. Finally, as I became anemic and my quality of life was completely diminished from the bleeding, I opted to have the ablation done. I was well educated and informed of the procedure and knew it could create fertility issues. The same doctor also told me the state I was in, was a fertility issue, and pregnancy would not be likely either. So I elected to have the procedure done, in hopes that my life would bounce back to normal. Thankfully it did! I continue to have a monthly cycle with a light to moderate period each month that usually lasts 4-6 days. I have no regrets from the ablation procedure, as it gave me my life back. The only thing that saddens me from the procedure is that I am afraid I will no longer be able to conceive.  I have 3 healthy children from my previous marriage. My older two were full term vaginal delivery with no complications, my youngest was premature(born at 35 weeks) and c-section due to being breech. All three of my daughters( ages 9, 8, 4) are healthy, happy kiddos!

The thought of being unable to conceive had never really been a huge issue for me, until I met and fell in love with my husband. Although I have been blessed with 3 beautiful little girls, my husband has no children.  We both knew that having a child together may not happen; he knew fully the situation I had been faced with. We are at the point now where we are hoping to find answers. I had initial tests done that show I am ovulating, however, a dye test showed that my tubes are not open. My husband's analysis showed everything was normal with him.

Early on the Dr. that performed all of our tests mentioned inserting a balloon to make the cavity a normal shape, and then cutting away some of the scar tissue by having a minor outpatient surgery. He then later said he did not feel it was ethical for me to be a candidate for IVF, since no studies had ever been done on a case like mine. Of course we respect his decision and would never want anyone to jeopardize their beliefs for our family, but I wander if I'm the only one out there that faces this scenario. I am a teacher, my husband an accountant, we recognize the risks involved with any pregnancy. From a health stand point they told me delivering by c-section would be a must in case the placenta was attached, thus resulting in a hysterectomy. I would accept that as a risk. We asked if death was a concern, and he said he didn't think so, none of the cases he had found resulted in death. Our hope is to find someone some place who has helped a couple in our situation, or would be willing to help us. For some reason, my heart won't let this go and for some reason, I felt led to continue to search for answers and help. Any information or advice you can share would greatly be appreciated.

Answer
Hello Jalaynna from the U.S. (Kansas),

I just answered a similar question, so will paste the relevant part of the answer here.  It almost fits you exactly, so can know that you are not the only one asking this type of question.

The usual answer to your question would be NO you can't get pregnant, 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.

Endometrial ablation is a procedure where the uterine lining is destroyed by burning or freezing.  This then leaves scar tissue in its place, and since the lining layer has been removed, the uterus cannot form an endometrial lining and so bleeding stops.  If the ablation is done correctly, the entire lining is ablated so there will no longer be periods.  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 monthly.  Therefore, there is hope or a chance that implantation can occur, but if there is extensive scar tissue, this will prevent implantation by whatever means you choose to try for pregnancy.

If you are lucky enough to become pregnant, there is a risk of implantation problems, such as placenta accreta, which can be a risk to your life, but that is a "risk" and not a absolute.  Your doctor could try to remove the scar tissue from the uterus to open it, which doesn't work very well, but that will not necessarily correct the endometrial formation problem.  Without a normal and adequate endometrium, implantation cannot occur.  So, the most difficult part for you will be just getting pregnant.

There is an alternative.  The alternative is to do IVF and use a surrogate.  In this case, the child will be yours and your new husband's genetic child, but you won't have the ability to carry the pregnancy.  The eggs are removed from you using IVF and put with your husband's sperm.  The resultant embryos are then placed into the surrogate's uterus.  It is a more expensive procedure, because it involves a third person, but will allow a pregnancy to occur AND for you and your husband to have a genetic child.

Good Luck,

Dr. 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 twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate  

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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