Is Pregnancy Possible After a Hysterectomy?

Understanding How Pregnancy Is Possible After Surgery

Pregnant woman on couch, smiling
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If you have had a hysterectomy you may be wondering if you can become pregnant after the surgery. The simple answer is no, it is not possible to become pregnant after having a hysterectomy procedure. You will no longer need birth control to prevent pregnancy.  

This answer is true for millions of women, and while it is essentially accurate, the human body is capable of doing surprising things.

The completely accurate answer is that you won’t be able to become pregnant and carry the fetus to term.

Confusing, 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. You can fertilize an egg without a uterus, but you cannot carry a child without one.

Fact: 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 cervix, 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, or so it seems.

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 a complication that happens in less than 1 in 1,000,000 cases. 

So pregnancy is possible — although extremely rare — but carrying a fetus is not as the uterus has been removed. These rare pregnancies after a hysterectomy do not result in the birth of a child and they only happen in women who have a hysterectomy that leaves at least one fallopian tube intact.

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 there are options available for you.

If you choose an oophorectomy (removing 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, but carrying a fetus is not possible and the pregnancy will typically require the medication methotrexate to treat the ectopic pregnancy or even surgery to save the mother's life.

This type of pregnancy will not lead to the birth of a child. 

A Word From Verywell

Pregnancy after a hysterectomy is so rare that it is nearly impossible with one in a million odds, but when it does happen it is typically considered a 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 bear children after the surgical procedure.

Sources:

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

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