Endometrial Ablation without Permanent Sterilization (Vasectomy or Tubal Blockage) = Recurrent Abortion and Serious Risk of Patient Complications
I have met several patients over the years, now two in Frisco, that have had an endometrial ablation done by their physician without ensuring the patient or husband has been sterilized. Ablation only helps with heavy vaginal bleeding it does not prevent pregnancy. Essentially these patients are getting pregnant, the egg and sperm get together in the fallopian tube and then the hostile environment created by the ablation prevents implantation of the fetus. The result is a normal period containing the embryo.
If you know anyone in this situation, she should seek hysteroscopic sterilization via Adiana or vasectomy by her partner, as soon as possible. Eleven years ago, my then partner took a woman to the surgery center for Dilation & Curettage (D&C) because she had had an ablation performed by another physician and started bleeding profusely at home. Her pregnancy test returned positive and an ultrasound revealed a dead ten-week baby. When he performed the D&C in attempt to stop her bleeding it would not stop, the woman required four units of blood and an emergency hysterectomy because the patient had never had permanent sterilization. The baby tried to grow into the muscle of the uterus instead of the endometrial lining because it had been removed with the ablation.
For those considering endometrial ablation, our office policy is to either perform hysteroscopic sterilization or have the husband get a vasectomy before the ablation. This avoids any potential for the issues not above.
Remember, Endometrial Ablation is not a form of birth control.
Jonathan Weinstein, MD, FACOG