Our Summary

This study aimed to look at the rates of pregnancy in women who had undergone different procedures for abnormal uterine bleeding. The procedures analyzed were curettage, first-generation (1G) endometrial resection, and second-generation (2G) endometrial ablation.

The researchers looked at the medical records of almost 110,000 women in France who had been diagnosed with abnormal uterine bleeding and had one of these procedures between 2009 and 2015.

They found that of the women who had a 2G procedure, 1.5% became pregnant afterwards. This was significantly lower than the 10.1% pregnancy rate for the 1G procedure and the 11.1% rate for curettage.

However, the researchers caution that endometrial ablation (the 2G procedure) should not be seen as a sterilization method or an effective form of contraception. They recommend that women continue to use contraception, regardless of their age or menstrual status, unless either partner has been sterilized.

FAQs

  1. What were the rates of pregnancy found in the study for each procedure analyzed?
  2. Can endometrial ablation (the 2G procedure) be used as a method of sterilization or contraception?
  3. What is the recommendation for women who have undergone endometrial ablation in terms of contraception use?

Doctor’s Tip

. It’s important to remember that endometrial ablation is not a guaranteed method of preventing pregnancy. If you do not wish to become pregnant, it is crucial to continue using contraception even after the procedure. It’s always best to discuss your options with your healthcare provider to determine the best form of birth control for you.

Suitable For

Patients who are typically recommended endometrial ablation are those who have heavy or prolonged menstrual bleeding that has not responded to other treatments such as medication or hormonal therapy. Endometrial ablation is usually considered for women who have completed their childbearing or do not wish to have any more children, as pregnancy after the procedure can be risky. It is also important for patients to have a thorough evaluation by a healthcare provider to determine if they are a suitable candidate for the procedure based on their medical history and overall health.

Timeline

Before endometrial ablation:

  1. Patient experiences abnormal uterine bleeding that is not responding to other treatments.
  2. Patient consults with a gynecologist who recommends endometrial ablation as a potential solution.
  3. Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for the procedure.
  4. Patient schedules the endometrial ablation procedure and prepares for the surgery.

After endometrial ablation:

  1. Patient undergoes the endometrial ablation procedure, which involves the removal or destruction of the endometrial lining of the uterus.
  2. Patient may experience some cramping and discomfort immediately following the procedure.
  3. Patient is monitored for a few hours post-procedure and then discharged home to recover.
  4. Patient may experience light bleeding or discharge for a few days to a week after the procedure.
  5. Patient follows up with their gynecologist for post-procedure care and monitoring.
  6. Patient may experience reduced or no menstrual bleeding in the months following the procedure.
  7. Patient may need to use contraception to prevent pregnancy, as pregnancy rates after endometrial ablation are low but not zero.
  8. Patient continues to have regular gynecological check-ups to monitor their health and well-being.

What to Ask Your Doctor

Some questions a patient should ask their doctor about endometrial ablation include:

  1. What are the potential risks and complications associated with endometrial ablation?
  2. How long is the recovery period after the procedure?
  3. Will I still have periods after endometrial ablation, and if so, what changes can I expect?
  4. What are the chances of becoming pregnant after endometrial ablation?
  5. How soon after the procedure can I try to conceive if I want to get pregnant in the future?
  6. Will endometrial ablation affect my hormone levels or cause early menopause?
  7. Are there any restrictions on physical activity or sexual intercourse after the procedure?
  8. How long can I expect the results of endometrial ablation to last in terms of reducing or eliminating abnormal uterine bleeding?
  9. Are there any alternative treatments or procedures that may be more suitable for my specific condition?
  10. What follow-up appointments or screenings will be necessary after endometrial ablation?

Reference

Authors: Fernandez H, Toth D, Descamps P, Capmas P, Lamarsalle L. Journal: J Gynecol Obstet Hum Reprod. 2022 Jan;51(1):102259. doi: 10.1016/j.jogoh.2021.102259. Epub 2021 Oct 29. PMID: 34715403