Is Pregnancy Possible After a Hysterectomy?

Understanding How Pregnancy Is Possible After Having Hysterectomy Surgery

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Question: Is Pregnancy Possible After a Hysterectomy?

Answer:

The simple answer is no, it is not possible to become pregnant after having a hysterectomy procedure. The more accurate answer is you won’t be able to become pregnant and carry the fetus to term. Confusing, I know, but there is an exception to what seems to be an obvious rule that you can't have a pregnancy if you don't have a uterus. 

After a hysterectomy, you will no longer be able to bear children.

During the hysterectomy procedure the uterus, also known as the “womb,” is removed from the body. Some types of hysterectomies also remove the ovaries and fallopian tubes. 

The uterus is where a baby grows inside the body. Without the uterus it is impossible to carry a fetus to term. The ovaries and fallopian tubes are where eggs live until they move to the uterus through the fallopian tubes.  Without eggs being released, pregnancy is not possible. 

While a simple “No, you can’t get pregnant after a hysterectomy” is essentially true for the vast majority of women, there have been a few extremely rare cases of women who find that they are pregnant after a hysterectomy. This is an extremely rare complication that happens in less than 1 in 1,000,000 cases. While pregnancy is possible in rare circumstances, the fetus cannot be carried to term without a uterus.

So pregnancy is possible--although extremely rare--but carrying a fetus is not.

These rare pregnancies after a hysterectomy do not result in the birth of a child. 

How Does Pregnancy After Hysterectomy Happen?

To understand pregnancy after a hysterectomy, you have to understand the concept of an ectopic pregnancy. An ectopic pregnancy happens when a fertilized egg implants outside the uterus, often in the fallopian tubes, and can be life-threatening.

This condition is typically found when a woman seeks medical attention for excruciating abdominal pain. Even in women who have not had a hysterectomy, an ectopic pregnancy cannot become a traditional, healthy pregnancy.

In an “early” ectopic pregnancy after hysterectomy, the woman was actually having an ectopic pregnancy at the time of the procedure. The surgery is completed, and at some point after the procedure, the woman is found to have a fertilized egg growing in the fallopian tubes or another area of the remaining reproductive system.

A “late” ectopic pregnancy after hysterectomy is when a woman who has had a hysterectomy that leaves the ovaries intact experiences an ectopic pregnancy after surgery. Like any ectopic pregnancy, this may become a surgical emergency as the growing fertilized egg damages the fallopian tubes or other structures.

If you want to have children but you need a hysterectomy with an oophorectomy that removes the ovaries, you can have eggs harvested with the intention of later implanting a fertilized egg in the uterus of a surrogate.

If you are producing healthy eggs and will keep your ovaries after surgery, harvesting can be done before surgery, or they can be harvested after your hysterectomy.

Just remember that while getting pregnant is possible--in very rare cases--after having a hysterectomy, carrying a fetus is not possible and the pregnancy will typically require the medication methotrexate to treat or even surgery to save the mother's life. This type of pregnancy will not lead to the birth of a child. 

Everything You Need To Know About Hysterectomy Surgery

Sources:

Ectopic Pregnancy After Total Hysterectomy. Bruder, ML, Vigilante, M. 1973.

Intraabdominal Pregnancy After Hysterectomy. The New England Journal of Medicine. Accessed January 28, 2009. http://content.nejm.org/cgi/content/extract/349/16/1534

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