It would seem logical that, if a woman’s uterus has been removed, she is no longer able to give birth to children. But with the advances in assisted reproductive technology, women who have had a hysterectomy are often capable of having genetically-related children – it just requires some extra help.
A hysterectomy is the surgical removal of the uterus. The decision to have the procedure may not be an easy one, and sometimes it’s not a choice at all. Whether it’s due to severe pain or a cancer diagnosis, this major surgery is likely to be thoroughly researched before a final decision is made.
Sometimes, in the case of a severe infection or excessive bleeding after childbirth, an emergency hysterectomy may be performed. Typically, women with severe uterine fibroids, endometriosis (where tissue that normally lines the uterus grows outside of the uterus on the ovaries) or adenomyosis (where tissue grows inside of the uterus where it doesn’t belong) are candidates for hysterectomy, as are women who have been diagnosed with cancer of the uterus, ovary, cervix, or endometrium (which is another word for the uterine lining).
There are three main kinds of hysterectomies:
A supracervical or subtotal hysterectomy, where only the upper part of the uterus is removed and the cervix stays in place
A total hysterectomy, where the entire uterus and cervix are removed
A radical hysterectomy, where the entire uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina are removed
As long as the ovaries remain intact, they will continue to function. Depending on the reason for the hysterectomy, they may be removed during the hysterectomy in a procedure called oophorectomy to lower the risk for ovarian cancer. According to the Office on Women’s Health, however, “recent studies suggest that removing only the fallopian tubes but keeping the ovaries may help lower the risk for the most common type of ovarian cancer, which is believed to start in the fallopian tubes.” The decision to keep your ovaries if you are having a hysterectomy is a discussion for you and your doctor, but it’s generally recommended for most women.
Yes, it is possible to have an egg retrieval after a hysterectomy. While you would likely not qualify as an egg donor for someone else, your fertility clinic can explore options with you for your own IVF cycle. Your antral follicle count, or ovarian volume, are checked to judge the likelihood of a successful retrieval. You have an ovarian ultrasound to determine the condition and location of your ovaries, as they sometimes move after a hysterectomy. Your hormone levels are also monitored to determine where you are in your cycle so that egg stimulation and retrieval can be appropriately scheduled.
If your ovaries need to be removed during the hysterectomy, you can explore the option of harvesting your eggs first. This option will likely depend on your age; just as you are not able to donate eggs at 40 or later, you’ll want to consider the quality of any eggs retrieved. If they are healthy, they can either be frozen for a later attempt at fertilization or they can be fertilized right away with your partner or a donor’s sperm. The embryos can then be frozen until you’re ready to attempt IVF with a gestational carrier.
When you decide to build a family, it’s time to team up with an agency to start your surrogacy journey. A gestational carrier will undergo IVF, using either the eggs that you harvested and froze for later fertilization, frozen embryos, or perhaps embryos created with the help of an egg donor. A hysterectomy may be a difficult decision and one that may require a great deal of healing, both physically and emotionally. We are here to support you when you are ready and will walk with you through the process to building a family with the help of assisted reproductive technology, step by step.
And, are you a woman who enjoyed a healthy and successful pregnancy? Do you have friends or family who have suffered from infertility or need assistance from someone else to build their family? Have you ever considered the role you could play in helping someone else build their family - as a surrogate? Talk to us to learn more about the surrogacy process to help someone else's dream come true.