Becoming a Mother after Hysterectomy: How to Do it?

By (embryologist), (embryologist) and (babygest staff).
Last Update: 02/03/2020

Hysterectomy is the partial or total removal of the uterus and is therefore a cause of infertility.

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.

Despite the loss of uterus it is still possible for a woman to fulfil her dream of becoming a mother.

What is Hysterectomy?

Hysterectomy is the irreversible and invasive surgical procedure to remove the uterus. This gynecological technique is performed through a large incision in the lower abdomen (laparotomy), but can also be performed through the vagina or by laparoscopy.

There are mainly three types of hysterectomy depending on the organs removed:

Partial hysterectomy
Only the uterus is extirpated.
Total hysterectomy
also known as complete hysterectomy. Consists of the removal of the uterine cavity and the cervix.
Radical hysterectomy
includes removal of the uterus, cervix and upper vagina.

Sometimes the third type of hysterectomy (radical hysterectomy) is accompanied by the total removal of the fallopian tubes and even the ovaries, which is known as a radical hysterectomy with Ovariectomy.

Indications

One of the main reasons a woman has a hysterectomy is uterus cancer or cervical cancer. However, this is not the only reason why a uterus has to be removed.

Other causes that lead to hysterectomy include the following:

  • Severe endometriosis.
  • Complications during or after delivery.
  • Uncontrollable vaginal bleeding.
  • Uterine prolapse.
  • Adenomyosis.
  • Molar pregnancy.
  • Poorly performed abortion.
  • Chronic pelvic pain.

Although in some cases these alterations can be solved with less invasive methods, there are situations that require the removal of the uterus, since not doing so could be a real danger to the woman's health.

Hysterectomy procedures

There are several options for removing the uterus depending on how and where the cut is made. The following describes the different procedures for hysterectomy:

Laparotomy
a large cut, about 10-15 cm, is made in the abdomen.
Vaginal hysterectomy
the cut takes place in the vagina and through it the uterus is removed.
Laparoscopy
between 2-4 small cuts are made in the abdomen. The main advantage of this surgical procedure for performing a hysterectomy is that it is a minimally invasive technique.
Robotic surgery
a robotic arm is used, but the process is similar to a laparoscopy.

In all these procedures, the patient is lying on her back. Specialists may place a urinary catheter to empty the bladder. Also, the woman is anesthetized, so she won't feel any pain.

However, it will be the surgeon in charge of making the final decision on the type of procedure to perform the hysterectomy according to each particular case.

Risks and consequences

Although hysterectomy is a fairly safe gynecological technique and should not pose any problems, complications can arise as in all major surgery.

These are the risks associated with hysterectomy:

  • Blood clot formation.
  • Infection.
  • Excessive bleeding.
  • Injury to the urinary tract and nearby organs.
  • Beginning of the menopause.

It should be noted that a woman may experience anxiety when faced with this procedure. Therefore, it is of vital importance to receive all the necessary information and to follow the guidelines established by the doctor.

Also, menstruation will stop and therefore, a woman will no longer be able to get pregnant after a hysterectomy. Additionally, the patient may experience vaginal dryness, hot flashes and/or night sweats.

Becoming a mother without a womb

As we have said, the human condition that allows a woman to give birth to a child is the presence of the womb. Without this organ, pregnancy and birth cannot take place.

However,there are numerous advances in reproductive medicine nowadays that allow a hysterectomized woman (without a uterus) to become a mother despite not being able to get pregnant naturally or by conventional assisted reproduction techniques.

Uterus transplant

Uterine transplantation is a highly complex surgical technique in which a healthy donor uterus is introduced into the recipient woman. Through uterine transplantation, the female recipient of the organ can achieve pregnancy and become a genetic mother.

However, this surgical procedure is still in experimental fases and involves risks for both the donor and the recipient. To be more precise, there are currently only 70 uterine transplants worldwide.

Surrogacy

When a woman loses her uterus, it does not necessarily mean that she loses her ovaries. Therefore, her eggs can be used to to carry out an in vitro fertilization treatment.

However, the embryo transfer cannot be performed on this woman, as she has no uterus. For this reason, it will be necessary to resort to another woman to whom the embryos will be transferred. Thus, surrogacy with IVF is the only alternative for a woman without a uterus to have own genetically related children.

The embryos are created by fertilizing the hysterectomized woman's eggs in the laboratory with sperm from the couple or a donor. These embryos are then transferred to the pregnant woman's uterus and after the pregnancy and delivery period, the baby will be delivered to its mother.

In cases where the woman has lost her uterus and ovaries or when eggs are not of good quality, there is the possibility of carrying out surrogacy with donor eggs.

Without a doubt, surrogacy is a procedure that requires a great deal of solidarity on the part of the surrogate mother. It should be noted that, depending on the legislation of each country, surrogacy will or will not be permitted.

Adoption

Adoption is another option a woman has, whether she is single or in a relationship, to become a mother after having her uterus removed.

This alternative has the disadvantage that the future baby will have no genetic relationship with its future mother. Even so, adoption is a path that many women without a uterus choose in order to have a child.

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

Gestational surrogacy, as any other medical procedure, requires that you rely on the professionalism of the clinic and agency you are working with. Logically, each one follows a different methodology. This tool can tailor an exclusive report for you in order to help you make a well informed choice. Our specialists will filter by company, taking your preferences and our strict selection criteria into account. The ultimate goal is to choose the best possible option for you.

FAQs from users

Does hysterectomy affect fertility?

By Marta Barranquero Gómez (embryologist).

The answer is yes. Hysterectomy, or removal of the uterus, is an irreversible surgical procedure that blocks menstrual cycles. For this reason, a woman's chance of becoming pregnant is virtually zero.

The uterus is the necessary organ for the implantation of the embryo to achieve a gestation. If this organ is missing, the woman will not be able to get pregnant naturally or by conventional assisted reproduction techniques.

What alternatives do I have to become a mother without a womb?

By Marta Barranquero Gómez (embryologist).

A woman who has had a hysterectomy or uterine removal has 3 alternatives in order to achieve her desire to become a mother: uterine transplant, adoption or surrogacy.

Is a smear test necessary after hysterectomy?

By Marta Barranquero Gómez (embryologist).

A Pap test is not necessary when hysterectomy is performed as treatment for a non-cancerous disorder.

However, the same is not true when the uterus is removed because of a cancerous or precancerous condition of the cervix. In these situations, your doctor recommends continuing to perform routine Pap tests.

What tips should I follow after hysterectomy?

By Marta Barranquero Gómez (embryologist).

After a uterus extirpation, walking is recommended to prevent the formation of blood clots. Additionally, it is important to reduce stress and not to pick up heavy objects.

As far as sexual relations are concerned, it is advisable to wait about a week to have full intercourse, i.e. with penetration.

Suggested for you

One of the alternatives to becoming a mother after a hysterectomy is adoption. For detailed information on this topic, read the following article: How can a child be adopted? - Types of adoption and procedures.

Another option for women to become mother without a womb is surrogacy. If you would like more information about the countries where surrogacy is allowed by law, we recommend you visit the following article: International surrogacy: Where is it legal?

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

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
 Marta Barranquero Gómez
Marta Barranquero Gómez
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
Adapted into english by:
 Romina Packan
Romina Packan
Babygest Staff
Editor and translator for the Babygest magazine in English and German. More information about Romina Packan

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