Endometrial Ablation

Definition - What does Endometrial Ablation mean?

Endometrial ablation is an office procedure used to ablate (remove or destroy) the inner lining of the uterus (endometrium) in women who have heavy menstrual bleeding. After ablation, the muscular layers of the uterus on either side collapse onto each other, with the damaged tissue shrinking and developing into a scar. The scar traps any endometrial tissue left behind after the ablation, impeding further bleeding. Because the endometrium is the site of embryo implantation, this procedure negatively impacts fertility and should not be done in women who have a desire for future childbearing.

FertilitySmarts explains Endometrial Ablation

Endometrial ablation is mostly reserved for women with bleeding of ovulatory origin when traditional therapies have failed. The procedure is carried out in women who have normal endometrial cavities but haven’t approached menopause or are close to menopause.

In women with heavy bleeding who are past menopause, endometrial ablation is best avoided due to the risk of hidden cancer. Other conditions where the procedure is not recommended include:

  • Pregnancy or desire to preserve reproductive potential
  • Excessive growth of the endometrium as in endometrial hyperplasia
  • Uterine or endometrial cancer
  • Damage to the uterus or endometrium
  • Active pelvic infection
  • Having a contraceptive coil in the uterus
  • A desire to preserve the uterus

Although the chances to conceive after endometrial ablation become quite slim, pregnancy can still occur as the ovarian function is intact. However, conception is best refrained due to the higher risk of complications to both the mother and baby, some of which are as follows:

  • Miscarriage
  • Pregnancy outside of the uterus (ectopic pregnancy)
  • Baby lying abnormally in the uterus
  • Placenta attaching abnormally or incapable of being separated after birth, giving rise to massive bleeding
  • Premature delivery of the baby
  • Growth restriction of the baby within the uterus
  • Death of the baby during labor and delivery
  • A need for an emergent Cesarean section because of life-threatening distress to the mother and/or baby
  • A need for an emergency hysterectomy due to uncontrollable bleeding at the time of delivery or after birth

The procedure just nips the bleeding in the bud but does not address the underlying problem causing the bleeding such as ovulatory dysfunction or fibroids. Moreover, a small percentage of women may experience no change in their heavy periods after endometrial ablation.

The ablation procedure is quick and relatively painless. These benefits are largely due to the use of global endometrial ablation (GEA) devices that can treat the entire endometrial cavity at the same time as well as require less training to attain superior outcomes.

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