It is a common concern for individuals undergoing a hysterectomy to question its impact on their ability to have biological children. While a hysterectomy permanently alters a person’s reproductive capacity, advancements in reproductive medicine offer possibilities for family building, depending on the specifics of the surgical procedure. The factor often revolves around whether the ovaries remain intact after the surgery.
Hysterectomy and Ovarian Function
A hysterectomy is a surgical procedure involving the removal of the uterus, also known as the womb. This organ is central to pregnancy, as it is where a fertilized egg implants and develops. After a hysterectomy, natural pregnancy is no longer possible because the uterus, which carries the pregnancy, has been removed.
There are different types of hysterectomies, and the distinction is important for fertility. A total hysterectomy removes the entire uterus and cervix, while a supracervical or partial hysterectomy removes only the upper part of the uterus, leaving the cervix intact. A hysterectomy may or may not include the removal of the ovaries, a procedure called an oophorectomy. If ovaries are removed with the uterus, it is called a hysterectomy with oophorectomy.
The ovaries are reproductive glands that produce eggs and hormones like estrogen and progesterone. If retained during a hysterectomy, they continue to function, which is important for future fertility options. However, even with intact ovaries, the absence of a uterus means natural conception and carrying a pregnancy are not possible.
Egg Retrieval Feasibility
Egg retrieval is possible after a hysterectomy, provided the ovaries were retained during the surgery and remain functional. This procedure is a component of in vitro fertilization (IVF) and can be performed even without a uterus. If both ovaries were removed during the hysterectomy, egg retrieval is not possible, as there are no eggs to collect.
The process of egg retrieval begins with ovarian stimulation. This involves administering hormone injections for about 10 to 12 days to encourage the ovaries to produce multiple mature eggs. Follicle development is monitored through ultrasounds and blood tests. Once follicles reach an optimal size, a “trigger shot” is given to prepare the eggs for retrieval.
The egg retrieval procedure is a minor surgical intervention performed under light sedation, ensuring the patient’s comfort. A doctor uses an ultrasound to guide a thin needle, inserted through the vaginal wall, directly into the ovarian follicles. Gentle suction retrieves the eggs from each follicle. Retrieved eggs are immediately transferred to a laboratory for assessment and preparation for freezing or fertilization. This entire process takes about 15 to 30 minutes, followed by a brief recovery period.
Pathways to Parenthood After Hysterectomy
For individuals who have undergone a hysterectomy but retained their ovaries, egg retrieval opens a pathway to genetic parenthood through gestational surrogacy. The retrieved eggs are fertilized with sperm in a laboratory to create embryos. These embryos are then transferred to the uterus of a gestational surrogate, who carries the pregnancy to term. The child born through gestational surrogacy is genetically related to the egg and sperm providers, but not to the surrogate.
If a hysterectomy involved the removal of both ovaries, making egg retrieval impossible, other options for biological parenthood still exist. Donor eggs can be utilized. Embryos are created in the laboratory using sperm and eggs from a donor. These embryos are then transferred to a gestational surrogate, who will carry the pregnancy. This allows individuals to experience parenthood, even without their own eggs, by using assisted reproductive technology and a gestational carrier.