Pregnancy following rollerball endometrial ablation

Objective To report a pregnancy occurring after rollerball endometrial ablation, and to review the literature in order to place this uncommon event in a clinical perspective. Case report An intrauterine pregnancy proceeded to a successful Caesarean delivery at term in a 43-year-old woman who conceived 33 months after a therapeutically effective rollerball endometrial ablation. World perspective Some 39 pregnancies following endometrial ablation have now been reported in the literature. Most (n = 27) of the known pregnancies have miscarried or been terminated. There has been one report of an ectopic pregnancy, and 11 pregnancies have proceeded beyond 20 weeks’ gestation. In the latter group the risk of obstetric complications is very high. Many pregnancies appear to have gone unreported. Conclusion Complete removal of the endometrium and complete obliteration of the tubal ostia cannot be guaranteed, and thus concurrent tubal interruption or continued contraception need to be considered for women proceeding to endometrial ablation.