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Friday, April 26, 2013

Best Contraception or Sterilization Technique If You Also Want (Or Have) And Endometrial Ablation

Endometrial ablation technology controls heavy menstrual bleeding but it doesn't provide adequate contraception. If there remains any viable endometrium (uterine lining tissue) then a woman can still get pregnant, thus contraceptive planning at the time of endometrial ablation is very important. Pregnancy after the endometrial ablation is considered dangerous. At least 1/3 pregnancies after an ablation will miscarry, there is a 5 times greater ectopic pregnancy rate, there is up to a 30% risk of premature birth, and there is a 25% risk of the placenta being implanted abnormally. There have been rare reports of uterine rupture during pregnancy and also cases of bands growing in the uterus that can cause several fetal deformities. And the newest MRI studies show that 95% of women with prior endometrial ablation will still have some viable endometrial tissue. Even women who no longer get menstrual cycles will still likely have some small amount of viable uterine lining tissue and have to take care to not get pregnant. For those using birth control for hormonal symptoms or other reasons, such as to control ovarian cysts, they can stay on the oral contraceptives. There has never been a study that says the hormones in oral contraceptive pills causes the ablation not to work. You cannot use an IUD if you have had a prior endometrial ablation, but you can have a sterilization procedure after any of the endometrial abolations. If you get the sterilization procedure prior to the endometrial ablation, you could consider getting an Essure sterilization. The Essure procedure needs to be done 3 months prior to the ablation so that it can be checked properly for coil placement. A tubal sterilization via laparoscopy with or without banding can be done at any time, even in conjunction with an ablation procedure. About 1/5 women who have sterilization procedures will regret having done so. But oddly only about 6% of women who's husband has a vasectomy express regret. Sterilization regret after an ablation was already done hasn't been studied. There are a number of factors to consider when it comes to the best contraception after an ablation, and it's definitely a topic to gab to your gyno about.

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