Our Summary

This study investigated how women who got pregnant after having a specific treatment for uterine fibroids fared. The treatment, known as transcervical fibroid ablation (TFA), uses a special kind of energy (radiofrequency) to tackle fibroids, which are uncomfortable or painful growths in the uterus. The device used for this is called the Sonata System.

The study collected data from 28 women across several countries who reported pregnancies after having the TFA treatment. These women had a total of 36 pregnancies, with 20 of them resulting in births. Some of these women got pregnant more than once after the treatment, and some needed help from fertility treatments to conceive.

The researchers found that there were 8 vaginal births and 12 C-sections. There were also 3 medically induced abortions and 8 spontaneous abortions in the first trimester, half of which happened to a woman with a history of recurrent pregnancy loss and an immunological disorder. Five women are currently pregnant.

Importantly, all the newborns were healthy, with good health scores (Apgar scores), appropriate weight, and none were born very prematurely. There were no cases of stillbirth, heavy bleeding after birth (postpartum hemorrhage), or uterine rupture.

The researchers concluded that women who have the TFA treatment with the Sonata System seem to have normal pregnancy outcomes, even those who have a history of recurrent abortions or who need fertility treatments to conceive.

FAQs

  1. What is the transcervical fibroid ablation (TFA) treatment?
  2. What were the findings of the study on women who got pregnant after having the TFA treatment?
  3. Did the TFA treatment have any negative impact on the health of the newborns?

Doctor’s Tip

One helpful tip a doctor might tell a patient about uterine ablation is to discuss any future plans for pregnancy with their healthcare provider before undergoing the procedure. It is important to understand the potential impact of uterine ablation on fertility and pregnancy outcomes. Additionally, patients should follow their doctor’s recommendations for post-procedure care and attend all follow-up appointments to monitor their health and well-being.

Suitable For

Patients who are typically recommended uterine ablation are those who suffer from heavy menstrual bleeding, also known as menorrhagia, and have not responded to other treatments such as medications or hormonal therapies. Uterine ablation is considered a minimally invasive procedure to reduce or eliminate menstrual bleeding and may be recommended for women who have completed their childbearing years or do not wish to have children in the future. Women with uterine fibroids, endometrial hyperplasia, or adenomyosis may also be candidates for uterine ablation. It is important for patients to discuss their individual medical history and concerns with their healthcare provider to determine if uterine ablation is the right treatment option for them.

Timeline

Before uterine ablation:

  1. Patient experiences symptoms of uterine fibroids such as heavy menstrual bleeding, pelvic pain, frequent urination, and constipation.
  2. Patient undergoes diagnostic tests such as ultrasound or MRI to confirm the presence of fibroids.
  3. Patient discusses treatment options with their healthcare provider and decides to undergo uterine ablation as a minimally invasive option.

After uterine ablation:

  1. Patient undergoes the TFA treatment using the Sonata System to target and shrink the fibroids.
  2. Patient may experience mild cramping or discomfort after the procedure, which typically resolves within a few days.
  3. Patient follows up with their healthcare provider for monitoring and to assess the effectiveness of the treatment.
  4. Patient may experience improvements in their symptoms such as decreased menstrual bleeding and relief from pelvic pain.
  5. If the patient desires to become pregnant, they may discuss fertility options with their healthcare provider.
  6. If the patient becomes pregnant after the TFA treatment, they may undergo additional monitoring and care to ensure a healthy pregnancy and delivery.

What to Ask Your Doctor

  1. Is it safe for me to get pregnant after having uterine fibroid ablation with the Sonata System?
  2. Are there any potential risks or complications I should be aware of if I become pregnant after the treatment?
  3. Will the fibroids come back or affect my pregnancy in any way?
  4. Should I wait a certain amount of time after the ablation procedure before trying to conceive?
  5. Will I need any special monitoring or care during pregnancy if I have had uterine fibroid ablation?
  6. Are there any lifestyle changes or precautions I should take during pregnancy after having this treatment?
  7. Are there any specific symptoms or warning signs I should watch for during pregnancy after uterine fibroid ablation?
  8. Will the ablation treatment impact my ability to have a vaginal birth or increase the likelihood of needing a C-section?
  9. How will the treatment affect my fertility and chances of getting pregnant in the future?
  10. Are there any additional steps I should take to ensure a healthy pregnancy after having uterine ablation?

Reference

Authors: Christoffel L, Bends R, Toub D, Schiermeier S, Pschadka G, Engelhardt M, Quinn S, Hartmann M, Habiba M, Felberbaum R, Brössner A, Schippert C, Römer T. Journal: J Gynecol Surg. 2022 Jun 1;38(3):207-213. doi: 10.1089/gyn.2021.0136. Epub 2022 Jun 13. PMID: 35785107