I had an endometrial ablation about two years ago. I have begun to have a regular period again. Can I consider fertility treatment?

D.B.

Endometrial ablation is a procedure performed instead of hysterectomy to control abnormal uterine bleeding that cannot be adequately controlled with hormonal therapy. It is performed as a simple outpatient surgery. The traditional technique, hysteroscopic ablation, involves placing a surgical tool with a viewing device through the cervix into the uterus while you are asleep. An electrosurgical probe then vaporizes or cuts out the endometrium (uterine lining). Newer methods have recently been introduced that simplify the procedure, by using balloon catheters or freezing probes. However, these methods do not appear to be as effective at stopping menstrual bleeding when compared to the traditional hysteroscopic techniques.

Women are advised that they should have this procedure only if they do not want to get pregnant in the future. Yet some women fail to follow this recommendation and find themselves pregnant in the years after the procedure. Unfortunately, the procedure destroys so much of the uterine lining that it is rarely able to support the developing pregnancy. These pregnancies usually end in miscarriage.

I would not advise a woman who has had this procedure to attempt pregnancy. If you do want a child from your egg, your best option is to undergo IVF egg retrieval and transfer the fertilized eggs to a gestational surrogate -- someone who could carry the pregnancy for you.