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  • Q&A with Australian Health Practitioners

    Can I have a baby/IVF after an ablation 14 years ago?

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    Infertility Women's Health
    I am 41, had my tubes clamped 15 years ago after final child. 1 year later had an ablation for painful periods, continued having periods and still do. 4 years ago had 1 ovary removed due to a dermoid cyst. New husband and I would love a child, do we stand a chance? Or should we stop thinking about it..
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    Thanks

    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Hi there,

    If you are having a regular period, then you are still ovulating. Therefore there is a good chance you are still fertile and producing eggs. Based solely on your age, your rate of infertility is about 30%.

    The problems lie in the following points:

    1. Endometrial ablation: According to most studies, despite destruction of the endometrium, 1% of women can fall pregnant after an ablation. The pregnancy would be a high risk pregnancy with a risk of miscarriage, abnormal placentation, preterm delivery, and fetal demise. Pregnancy is usually contraindicated after an ablation. There aren't enough studies in the medical literature looking at the best management of a pregnancy post-ablation. Close monitoring and regular scanning would be the minimum requirements.
    2. Tubes are clamped. IVF would be the most likely route for the pregnancy, or microsurgery to the fallopian tubes to repair them.
    3. Painful periods which may indicate you have a condition called endometriosis which would predispose you to further reduction in fertility.
    4. You only have 1 ovary which may indicate that your ovarian reserve is lower than normal.

    Your partner would need his Semen Analysis performed as there may be a male factor component infertility.

    Considering these risks is very important in your decision making. IVF would give you the best chance of pregnancy, but it will come with risks, low success rate and both psychological and financial costs. The alternative would be surrogacy or adoption. 

    I would recommend you obtain a referral to a Fertility Specialist and discuss your options further.

    All the best.

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