The uterus, also described as the womb, is where a baby grows during pregnancy.
Hysterectomies are common procedures. In fact, one in three females in the U.S. has a hysterectomy by age 60. The decision is not taken lightly—it has many effects, including permanently eliminating the ability to carry a pregnancy.
Ectopic Pregnancy After Hysterectomy
Sometimes during a hysterectomy procedure, the cervix, ovaries, and fallopian tubes are also removed. In this case, the surgery is called and hysterectomy and bilateral salpingo-oophorectomy. When the cervix is not removed during a hysterectomy, the procedure is called a supracervical or subtotal hysterectomy.
In very rare cases, someone who has had a hysterectomy will experience ovulation (release of an egg that can become fertilized) and subsequent fertilization (conception), resulting in an abnormal and dangerous situation known as an ectopic pregnancy.Also known as a tubal pregnancy, an ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most often in a fallopian tube.
An ectopic pregnancy can occur after hysterectomy only if at least one fallopian tube and one ovary have been left intact.
Risk factors for ectopic pregnancy after hysterectomy:
This has occurred in rare instances when people had a very early pregnancy prior to surgery and before a pregnancy test was able to detect the pregnancy. It can occur in extremely rare instances if a supracervical or subtotal hysterectomy was done.
Ectopic pregnancy can become life-threatening as the fetus continues to grow, eventually causing a major rupture and internal hemorrhage. The first sign is usually excruciating abdominal pain.
After diagnosis, a doctor will typically prescribe medication (methotrexate) to eliminate the fetal cells. If that is ineffective, surgical removal of the pregnancy and repair of the fallopian tube may be done via laparoscopy. If there is an active rupture, emergency surgery (laparotomy) may be needed.
Having a Child After Hysterectomy
If you want to have children but you need a hysterectomy for medical reasons, it is possible for you to start a family. While you might be able to use your own eggs, you can’t carry the pregnancy yourself.
One option is to have your eggs harvested for future fertilization and surrogate implantation. Harvesting can be done before the surgery if your ovaries will be removed, or after surgery if your ovaries are to remain intact. While a surrogate will carry the child, it will be your biological child.
If egg harvesting is not possible or you do not wish to go that route, there are other options. A male partner may provide sperm for a surrogate pregnancy, either of a donor egg or the surrogate’s egg. A female partner may carry a pregnancy resulting from her egg being fertilized. You may also consider adopting a child as an alternative.
A Word From Verywell
Pregnancy after a hysterectomy is extremely rare, but when it does happen it, is considered a life-threatening medical emergency. If you want to become pregnant, you will need to do so prior to having a hysterectomy, as it will no longer be possible to carry a pregnancy after your uterus is removed. You also have other options, and some of these options might include using your own eggs.
