It is a question that has been revolving in the minds of mothers who do not have one and the specialists researching on the issue for years. Other questions that anyone with this complication can ask include:
- What is hysterectomy?
- Will it be possible to carry a child without a uterus?
- What is the cost of letting another woman carry the child for me?
The information below seeks to answer these questions by shedding light on:
- What is Hysterectomy?
- What are the chances of getting pregnant without a uterus?
- Removal of ovaries and fallopian tubes
- How pregnancy happens after hysterectomy
- 9 facts to be aware of if you do not have a uterus
- You should know about uterus transplant
Table of Contents
- What Is Hysterectomy?
- What Are The Chances of Getting Pregnant Without A Uterus?
- Removal of Ovaries and Fallopian Tubes
- How Pregnancy Happens After Hysterectomy
- 9 Facts to Be Aware of If You Do Not Have a Uterus
- 6 Things You Need to Know About Uterus Transplant
It is a surgical operation done to remove the uterus and other female reproductive organs. The reasons behind having a hysterectomy include:
- Agonizing pain and bleeding due to uterine fibroids
- Cancerous cells in the womb, ovaries or cervix
- Uterine prolapse:The uterus sliding from its initial position to the vaginal canal.
- Uterus thickening, also known as adenomyosis.
- Endometriosis:The endometrium being elsewhere other than in the lining of the uterus, causing premenstrual pain and dysmenorrhea.
- Excessive and abnormal bleeding from the vagina
- Inveterate pelvic pain.
If the reason for hysterectomy is noncancerous, the medical practitioners will first try other treatments before considering it as the last option.
Different Hysterectomy Types
It is always dependent on the reason where the surgeon operating may choose to either remove the whole uterus or parts of it. Sometimes, what patients and specialists refer to is not always precise which necessitates the importance of clarifying if the ovaries and ovaries will be part of the removal.
- Supracervical/subtotal hysterectomy:The removal comprises of the upper uterus part but the cervix is left behind.
- Total hysterectomy:Whole uterus and cervix removal.
- Radical hysterectomy:It is viable if you have cancer. The whole uterus is removed, uterus side tissues, cervix and the top vagina part.
Other operations that the surgeon can carry out though not necessary unless it is vital:
- Oophorectomy:Removal of ovaries.
- Salpingectomy:Removal of fallopian tubes
What Are The Chances of Getting Pregnant Without A Uterus?
If there is no uterus, then do not expect a healthy pregnancy. It might sound harsh, but if a female has her uterus removed, whether full or partial hysterectomy, then the chances of giving birth from the operated body are almost 0%.
However, if the ovaries and tubes are left intact, there is a possibility of an egg being released and get fertilized by a sperm. The rare opportunity window after hysterectomy is what we call an ectopic pregnancy.
If the developing fetus gets sufficient blood supply to support growth, further development will proceed for the next few weeks. It is a life-threatening situation since a pregnancy rupture is bound to occur at any point as you carry which results in severe bleeding. Only surgery can stop the excessive loss of blood.
It is not easy to detect an ectopic pregnancy. Bleeding and abdominal pain occurrence may prompt the woman in pain to contact the doctor and surgery becomes the next step in saving the mother’s life.
Removal of Ovaries and Fallopian Tubes
During the surgery procedure, the ovaries and tubes can be:
- Left out after removing the uterus,
- Partially removed meaning one of the sides will remain intact OR
- Totally removed with or without removing the uterus and/or cervix
If you had an ovary or one of the tubes removed, but the uterus remains in place, the odds of pregnancy in the future are on your side. For a successful egg release and fertilization, one ovary and fallopian tube is enough.
This kind of removal is what the medical experts refer to as Oophorectomy and Salpingectomy for the ovary and fallopian tube removal respectively. On the other hand, most women undergoing the procedure would still call it hysterectomy.
If the uterus is removed in the process, you can still utilize the surrogate mothers option where someone else will carry it for you. One thing to remember though, it is a viable option only if you still have one or all ovaries. The practitioners will help you harvest the eggs, fertilize them outside the body then subject them to the selected surrogate for carrying purposes.
Those of us who have removed both ovaries and fallopian tubes, the uterus may or may not be part of what is getting out of your body. If all of the mentioned parts are victimized, then you have experienced full removal of the vital reproductive system organs and the chances of becoming pregnant fall to zero.
Among the affected organs include the cervix which is often removed and the surgeon will suture the vagina’s upper end. At this point, you will be in a surgical menopause and the sperms will have no passage to fertilize the unavailable eggs.
After the hysterectomy practice, chances that you will be pregnant again will depend on how you define the process. Hysterectomy is another definition of a sterile woman. If one of the tubes and ovary is functioning as intended, the worry of being infertile is somehow minimal.
However, if scarring occurs during organs’ removal, future complications when you get pregnant again might be inevitable.
Becoming pregnant after the uterus and other organs removal procedure needs you to be well aware of an ectopic pregnancy. It occurs when an egg fertilizes but implantation happens in another place, mostly in the fallopian tube which puts the mother’s life in danger.
Knowledge of the egg attaching elsewhere becomes available when the woman in question goes to see a physician due to harrowing abdominal pain. Bear in mind that even for mothers who have not yet experienced hysterectomy, contracting an ectopic pregnancy will not transform to a normal and healthy state afterward.
Categorizing different forms of ectopic pregnancy depends on when it was detected.
- ‘Early’ mode:It implies that the ectopic pregnancy is progressing during surgery. Upon the procedure’s completion, the doctors realize that a fertilized egg is developing in one of the tubes or another body part.
- ‘Late’ mode:After the hysterectomy, if the woman’s ovaries are still intact, the ectopic pregnancy occurs after the surgery. It then becomes another medical emergency since continued egg’s growth without a supportive structure leads to fatal damaging of organs and death if there is no early rectification.
If you are planning on having kids in the future, a hysterectomy gives you the following options:
- If you are about to undergo an oophorectomy, the eggs are harvested during surgery on request before the procedure for later fertilization and implanting in a surrogate.
- If you choose to keep the ovaries and they produce healthy ova, harvesting can occur before or after the removal.
One point to remember: Getting pregnant after hysterectomy is possible depending on how it was carried out but carrying the unborn is impossible. When the ectopic pregnancy comes, it will prompt you to get medication methotrexate for treatment or surgery if the situation is fatal.
You cannot deliver a child with this pregnancy type.
9 Facts to Be Aware of If You Do Not Have a Uterus
Apart from the surgical removal of parts of the reproductive system, one can be born without a uterus. Now, a question comes in, what is it like to live without a uterus? Do periods happen? In this section, we will be shedding light on what life is like for those who do not possess the significant player in pregnancy among other facts.
- In 5000 born women, only one comes without a uterus which means it is a rare case. Still, there are no precise statistics on the issue, but countries like Sweden and the USA have explored more on uterine transplant. You will see more on this in the next section.
- Most people think that it is a hereditary condition, but only a few cases can attest to the misconception. It is congenital meaning that it occurs when the fetus is developing.
- If you have a growing embryo, some factors could place it at risk. They include using medications that will have an overall effect on the fetus’ growth and getting exposed to toxins from the environment. Another threat comes in if fertilization went the wrong way. That is why you should think twice before going for fertility drugs.
- Since you do not possess a uterus, that means you do not experience any periods. However, having ovaries that are fully functional is a possibility since the cells used to make them are different from the cells set that make the vagina and uterus. Lack of a womb in most cases means that you do not have a vagina. However, the latter can be solved by having an artificial one.
- If the uterus is not present, but the ovaries are functioning, development of secondary sexual characteristics is bound to take place such hair growth and breast development. The ovaries are responsible for production of female hormones such as estrogen and progesterone.
- You cannot get pregnant because the uterus is not there. Since both the cervix and womb were either removed or did not develop, a uterine transplant is the only available option if you want to conceive. Another choice is going for surrogacy.
- You can have an active sex life if the there is no uterus but the ovaries and vagina are present and fully functional.
- In a normal pregnancy occurrence, the fertilized egg travels through the fallopian tubes and the uterus than takes place for implantation. However, since you do not have the womb, the egg released every month will be absorbed by the pelvis in the next 48 hours.
- No ovaries, vagina, and uterus bring in enormous hormonal changes in your body. Hormone production does not happen in the usual way so, the subjects may seem older than their counterparts in the same age. Lack of the needed hormones causes brittle bones and the risk of having cardiac complications. That is why women in this condition get the recommendation to have hormone therapy until she reaches 50-52 years of age. On the other hand, if the ovaries are not functioning but the uterus and vagina are intact, you can get an egg’s donor which will be fertilized and then implanted in your uterus. The fetus will not possess your genes, but you can be the biological mother.
6 Things You Need to Know About Uterus Transplant
You may have heard of numerous transplants from the kidney to the face but not a uterine transplant. It is a new technical procedure that gives hope to those who do not have a uterus, but they want to have kids. The first transplant happened in 2014 where nine women had operations after their relatives donated the organs. Five of them became pregnant, and four have already given birth.
It was an issue that raised many eyebrows and the Cleveland Clinic in the US took a step ahead to involve ten women in a transplant study. In 2017, the first woman among those who took part in the research has already given birth which is a relief to the doctors not to mention the huge stride in making the uterine transplant a possibility.
Since it a risky process that brought many hindrances in the course of experimentation, here is what you need to know about the procedure before you think about venturing:
1) Who is valid for the uterine transplant?
Doctors from the Cleveland clinic recommended the transplant to women suffering from a condition known as uterine factor infertility. It implies that they cannot bear children or become pregnant since they were either born without a uterus or have undergone a hysterectomy.
The uterus could also have been damaged by an infection or injury which renders it non-functional. The eligibility age is for women between 21-45 years, but those who have attained the age of 40 and above must have taken fertility treatments before they were 39 years old. If you were born without a uterus, the condition is known as Mayer-Rokitansky-Küster-Hauser syndrome.
2) When was the first transplant performed?
The first successful transplant was in Sweden where nine women took part in the study following donations from their relatives. The Cleveland clinic, however, went out of the family boundary to obtain the uteruses from cadavers (deceased donors).
It sounds weird but getting them from the deceased reduced the risk involved when a living donor undergoes a uterine removal. According to an article published in the New York Times, injuries may occur as surgeons try to get rid of the blood vessels that surround the uterus.
Due to the tricky work of avoiding cutting the blood vessels, operating a deceased donor reduced the 7-11 hours dedicated to the living. The road to more research is extending in the UK where the trial of transplants using the dead sources currently requires about $756,000 before commencing.
Upon receiving the transplant, one cannot become pregnant without the help of fertility treatments. Why? The uterus does not connect to the fallopian tubes so, normal fertilization is blocked.
The only option is vitro fertilization where the eggs are removed for fertilization before implantation in the uterus. One thing though, the doctors cannot look for a uterus donor before the one receiving takes an IVF, and the embryos are frozen.
After a successful pregnancy, delivery involves the C-section so that the uterus cannot bear the labor workload.
4) Are there any risks?
By now, you should know that a lot of risks are involved starting from the fact that the whole process is uncertain. Women receiving the transplants have to undergo a risky surgery procedure. Some critics question whether it is ethical since it is highly dangerous and life threatening as opposed to life saving.
Others argue that it improves the quality of life since a woman will be able to carry a child. It is very important to them. Furthermore, medicine prescriptions today focus on improving human well-being according to projections made by medical researchers.
On the transplant part, women need immunosuppressant drugs so that the organ works with the rest of the body. How these drugs affect the fetus development is not yet known. What we know is that they have side effects which include high risk of infection, and high chances of a preterm delivery. However, research performed on women who have undergone other transplants such as the kidney and later became pregnant showed that the drugs were safe for pregnancy.
Due to the use of cadaver donors, there is more uncertainty when compared to the Swedish study that involved relatives as viable donors. The prior may compromise the organs due their decline before death.
5) How long do women have to wait after the transplant?
According to the Cleveland Clinic, the waiting period is a year so that the uterus can heal before conducting implantation.
6) What next after giving birth?
After the first successful birth, the doctors can allow you to stay with the uterus if you are looking forward to another baby. If not, or after the second child, a hysterectomy has to take place so that you can stop consuming the immunosuppressant drugs which may lead to long-term effects.