Becoming a Mother after Hysterectomy: How to Do it?

By (embryologist) and (babygest staff).
Last Update: 02/10/2016

The female uterus is the organ where the embryo is implanted and subsequently develops into a fetus up to the time of birth. Therefore, it is an essential organ to be able to carry out the birth of a future child.

Removal of the uterus is known as hysterectomy and is a reason for infertility.

The different sections of this article have been assembled into the following table of contents.

What is hysterectomy?

Hysterectomy is the removal of all or part of the uterus. The main reasons why a woman undergoes removal of the uterus are:

  • Cancer of the uterus or cervix
  • Appearance of precancerous lesions
  • Severe endometriosis
  • Complications during or after childbirth
  • Uncontrollable vaginal bleeding
  • Uterine prolapse
  • Adenomyosis
  • Molar Pregnancy
  • Wrongly performed miscarriage

Although in some occasions these alterations can be solved with less invasive methods, there are situations or circumstances that force to carry out the extirpation of the uterus or hysterectomy, since not doing it could be a real risk for the health of the woman.

Being a mother without a uterus

As we have said, the human condition that allows a woman to give birth to a child is the presence of the uterus. Without this organ, gestation and childbirth cannot take place. However, advances in reproductive medicine allow a hysterectomized woman (without a uterus) to become a mother even though she cannot become pregnant.

The fact that a woman is left without a uterus by removal does not necessarily mean the loss of the ovary. Therefore, her eggs can still be used for in vitro fertilization (IVF). However, the embryo transfer cannot be carried out on its own, as it does not have a uterus, but must be carried out in the uterus of another woman.

The so-called surrogacy, an alternative to IVF in which a woman gestate another person’s or couple’s baby, emerges in this way. It’s the only option a woman without a uterus has to be able to have children of her own.

In this way, embryos would be generated by fertilizing the eggs of the hysterectomized woman who wants to be a mother. These embryos would then be transferred to the pregnant woman’s uterus and after the period of pregnancy and childbirth, the baby would be delivered to its mother.

In cases in which the woman has lost, in addition to the uterus, the ovaries and therefore her oocytes cannot be used or when the oocytes are not of good quality, there is the possibility of surrogacy with donor oocytes.

As for the seminal sample, it can be from the couple or from a donor of male gametes.

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Adoption

Adoption is another option for a woman, single or with a partner, to become a mother after undergoing uterine removal.

This alternative does not allow the future baby to have a genetic relationship with the one that is going to be his mother. In spite of this, it is a path chosen by many women without a uterus in order to have a child.

Socially, adoption is better accepted and involves less ethical controversy compared to surrogacy. However, the possibility that surrogacy offers over the fact of not having to renounce the genetic inheritance, means that surrogacy is chosen every day by more women who unfortunately have lost their uterus.

Uterine transplantation is another possibility these women have to become pregnant and give birth to their child. However, although there are already live newborns, this is an experimental technique with numerous complications.

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Authors and contributors

 Andrea Rodrigo
Andrea Rodrigo
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information about Andrea Rodrigo
Adapted into english by:
 Sandra F.
Sandra F.
Babygest Staff

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