Pregnancy Forum - Hysterectomy Fertilisation Pregnancy

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Q: Hysterectomy Fertilisation Pregnancy

asked by: Kia on April 18th, 2006

Moderator

Ok i'll try to keep this simple because I know how confusing it is.

First off in a "normal" woman when ovulation occurs the eggs are released from the ovary and the fallopian tubes have these little fingers on the end that encourage the egg into the tube (the egg doesn't always make it intot he tube) and the tubes are not attached to the ovary but they are connected to the uterus.

Sperm and egg usually meet up in the tube but sometimes it happens as late as in the uterus itself.

The uterus is shaped like and upside down pear (fruit).
In a complete hysterectomy they take the whole pear and sew up the top of the vagina leaving a "cuff" of scar tissue.
In a partial hysterectomy they only take the fat part of the pear and leave the thinner bit (cervix). Then they sew up the open part of the uterus to form a "pocket".

The tubes are usually removed because there isn't any need for them after a hysterectomy, but some surgeons leave them in place.
Removal of tubes and or avaries is nothing to do with a hysterectomy, a hyst deals with the uterus only.

Now, the scar line either at the top of the vagina or the pocket of the cervix can either not heal fully leaving a small fistula (hole/tract) or it can develop one in later years as the "skin" of the internal sexual organs becomes thinner.

A sperm is only 40microns (that is 0.0016 inches and there are 1000microns in one millimetre), a fistula may only be a millimetre or two and not noticeable but it sure as heck can let a lot of little spermies through, and we all know how many little spermies it takes to fertilise an egg - 1!

An egg from a woman who has had a hyst is viable for approx 36 hours (same as any other woman really) if after this time it is not fertilised then it will be absorbed back into the body.

Now from the pocket/cuff to the ovaries is a matter of maybe a inch or a couple of inches.
Sperm swim at a rate of 30 inches per hour.
They can easily pass through a fistula and "flood" the lower abdomen and if there happens to be an egg released from the oavery around that time then bam - you got an ectopic pregnancy on your hands.

Incidentally some ectopics occur in women when the sperm swim all the way up the fallopian tube before meeting an egg and the fertilised egg fails to enter the fallopican tube and instead embeds itself outside the uterus.

So to sum up - for joanna to be pregnant is not likely but is very very possible.

If you have any questions on this don't hesitate to ask, but please don't be ignorant and assume.
I have a wealth of research and if I ever went on mastermind it would be my chosen topic.

Replies(78)

DylanJacob

replied on April 18th, 2006

Experienced User

Wow - did .N.O.T know that. Didn't assume anything in the first place mind you.

Mabel

replied on April 18th, 2006

Moderator

How many pregnancies without uterus have lasted throught to full term? Where does the placenta attach? How many live births from this sort of pregnancy?

I am fully aware that there have been abdomenal pregnancies in woman with uteri, i'm asking about women without. Not women who have recently had a hysterectomy, mind you, but women who have gone nearly 2 decades after a hysterectomy.

AlliE_18

replied on April 18th, 2006

Extremely eHealthy

I agree its possible. But her babies would be dead by now kia, shes what 3 weeks past her due date? You know she'll still be here in a year saying shes been pregnant 2 years and god hasnt decided the time is right for them to be born yet .S.T.I.L.L

how do you make some words bold on here?

BelieveinMiracles

replied on April 18th, 2006

New User

Thanks kia for all the information. I recently had a vaginal hysterectomy where they left my tubes and ovaries in place. 4 weeks after the hysterectomy I set up a bad infection and my doctor had to go back in and do an incision and drainage this has been a very rough experience for me. He informed me that he wanted me to wait an additional 4-6 weeks before intercourse and now I see why. I really dont like to ask my doctor alot of questions because his bed side manner is not the greatest but I really appreciate you for explaining this in detail.

Bridgett

Kia

replied on April 18th, 2006

Moderator

ingi wrote:

how many pregnancies without uterus have lasted throught to full term? Where does the placenta attach? How many live births from this sort of pregnancy?

I am fully aware that there have been abdomenal pregnancies in woman with uteri, i'm asking about women without. Not women who have recently had a hysterectomy, mind you, but women who have gone nearly 2 decades after a hysterectomy.

if a woman sought medical attention it is most likely that the pregnancy would be removed in the early stages as a preventative measure.

The placenta can attach to pretty much any of the internal organs, but most commonly seems to attach to the bowel (neccessitating a colostomy in most cases) although it can even attach to the inner muscle wall of the abdomen itself.

There have been a couple of live births in pregnancy post hysterectomy.

Also note-worthy is that intra-abdominal pregnancy with live birth is statistically the same whether the woman has had a hyst or not because the uterus is factored out any way by the very nature of the pregnancy.

The fact that this "occurence" has happened so long after a hyst is what makes me think the "pregnancy symptoms" are actually menopause symptoms.
But the sheer fact that the case is not impossible is why I am unable to conclude.

*goes off digging in her achives on an old hard drive for case studies*

Kia

replied on April 18th, 2006

Moderator

Ok I need to find my old hard drive but here are some links I found in a quick google search - some you might not be able to fully read as they require subscriptions but you should be able to see a brief or abstract of the article.

Some are intra-abdomnal, some extra-uterine, but they all relate to pregnancy outside of a uterine environment - there seems to be some confusion surrounding the true number of cases recorded late post hysterectomy.

Remember some may need you to alter the caps in the link.

Http://health.Ivillage.Com/gyno/gynoreproh ealth/0,,5lh8,00.Html

http://query.Nytimes.Com/gst/fullpage.Html ?Sec=health&res=9404efda1031f934a15752 c1a962958260

http://www.Meb.Uni-bonn.De/dtc/primsurg/do cbook/html/x5173.Html

http://www.Obgyn.Net/english/pubs/articles /stone_baby.Htm

http://www.Ncbi.Nlm.Nih.Gov/entrez/query.F cgi?Cmd=retrieve&db=pubmed&list_ui ds=6553546&dopt=abstract

http://www.Popline.Org/docs/733337

http://jdm.Sagepub.Com/cgi/content/refs/1/ 4/157

http://sunny.Medinfo.Hu:8080/cgi-bin/w1.Sh ?Session=403897587&infile=details.Glu& amp;oid=99845&rs=737074&hitno=-1

arnold l. Sperling, md, mph, mba,
assistant clinical professor ob/gyn tufts medical school
boston, mass wrote:

i read dr sloan's article, "abdominal pregnancy revealed following vaginal hysterectomy" [sloan d. The female patient. Most interesting case: abdominal pregnancy revealed following vaginal hysterectomy. 2003;28(5):55-56]. Dr sloan's case is the twenty-second case of pregnancy after hysterectomy reported in the english literature.

Most of the cases were found immediately after hysterectomy was performed, but one case from australia occurred more than 10 years postoperatively.

I evaluated one case in new york city in which the proximal end of one fallopian tube was visible in the vagina at the vaginal cuff. This conception occurred 3 months postoperatively.

All of the reported cases had at least one tube remaining along with ovarian function.

It was obvious that most of these cases occurred with transuterine sperm migration, but it is also apparent that conception can occur without a uterus.

Certainly these cases are so rare that there is no need to change our practices regarding either abdominal or vaginal hysterectomy, but Dr. Sloan makes us clearly aware that pregnancy can, and occasionally does, occur post-hysterectomy.

marcus filshie, dm, frcog, mffp wrote:

there's a failure rate of any method of contraception including sterilization, as you know, and just to remind everybody, there are 23 cases of pregnancy following hysterectomy so you can't get a zero failure rate. If you look at all the studies that have been published, either in reference journals or in ordinary articles, and you look at all the figures that are available, the overall failure rate including the best which have got no failures or the worst which have got some failures, the overall failure rate is 2.7 per 1,000 patients during their lifetime. We call it a lifetime risk, it's not an annual risk - it's a lifetime risk.

Mabel

replied on April 18th, 2006

Moderator

Interesting articles. Thank you.

None of these articles contain live births 19 years post hysterectomy. The 8 months post op, I can actually believe. But 19 years and for it to have gone un-diagnosed, for so long with so many tests is, to me, unbelieveable. She may have had me on the hpt not being picked up. I may have been able to believe that. However, multiple ultrasounds and drawn on (very large) baby in the rib cage? No way. The facts that no one can find the baby/ies and they are now over 2 weeks late is quite fishy.

Considering her age, I would have to say the menopause theory is just as good as the .Cushing's disease theory. Whatever the case, as everyone has said every single thread, this person needs some kind of help.

Kia

replied on April 18th, 2006

Moderator

There is one in there (i think I found it and posted it) that was 11 or 13 years post op.

But anyway my point was not to say joanna is or isn't pregnant but that the possibility isn't impossible.

I mean if I ever had an ectopic that wasn't tubal (mine was growing in scar tissue and the beginings of the placenta were mal-formed so was a no-go) but otherwise I would definately, knowing what I know now comapred to 2 years ago, would hold out and hope.
Albeit I would definately be seeking medical observance.

AlliE_18

replied on April 18th, 2006

Extremely eHealthy

ingi wrote:

whatever the case, as everyone has said every single thread, this person needs some kind of help.

[allie quit posting such abominable statements - it is not big or clever and quite simply will not be tolerated]

AlliE_18

replied on April 19th, 2006

Extremely eHealthy

allie_18 wrote:

ingi wrote:

whatever the case, as everyone has said every single thread, this person needs some kind of help.

[allie quit posting such abominable statements - it is not big or clever and quite simply will not be tolerated]

[allie quit it ok. Telling people to commit suicide is abhorrent and you should be ashamed - post removed for that reason and if you re-post it again it will be reported]

notafan

replied on April 19th, 2006

Experienced User

Re: Hysterectomy Fertilisation Pregnancy

kia_breizzze wrote:

ok i'll try to keep this simple because I know how confusing it is.

so to sum up - for joanna to be pregnant is not likely but is very very possible.

very *very* *possible? That's stretching it. *remotely* one-chance-in-a-billion-possible? Perhaps.

Hysterectomy was done as a means of sterilization in years past for women who did not wish to bear more children. A woman without a uterus is considered sterile, infertile, as is a woman who has had tubal ligation. Yes, doctors could give hormones to increase egg production, gather eggs, fertilize them invitro, then ]implant them in another womans uterus, but the woman who has no uterus or has clipped/tied/cauterized fallopian tubes is infertile - unable to bear children. Women with deformed (septate, large fibroids) etc) uterii, congenitally absent uterii, are classified as infertile, and need reproductive technology and assistance to become mothers. Even if they have working ovaries, they are infertile.

There is also research that indicates that women who have undergone hysterectomy (but not oophorectomy), and do not take hrt go into menopause sooner than intact women - something about not having a uterus makes the ovaries kick off earlier.

So, in fatfamilys case - a woman in her mid-40's, 18 years post-hyst, is statically more likely to be going through menopause than she is to be pregnant.

Mabel

replied on April 19th, 2006

Moderator

Re: Hysterectomy Fertilisation Pregnancy

notafan wrote:

this sounds so much more plausible than the possibility of pregnancy, it is unbelieveable to me that anyone would still *believe*.

Right, there is a very *very* remote chance that a pregnancy could have happened. But to go undiagnosed - after xrays and ultrasounds!! - for 10 months already and be 18 days overdue? No way. That is not even realistic by the largest stretch of the imagination.

Notice how she backtracked on the 'twins' in her last statement. Now it is probably just a singleton. Whatever. Still not within the realm of reality.

AlliE_18

replied on April 20th, 2006

Extremely eHealthy

Um ok whoever wrote that! It was kinda funny though

Kia

replied on April 20th, 2006

Moderator

Re: Hysterectomy Fertilisation Pregnancy

notafan wrote:

so, in fatfamilys case - a woman in her mid-40's, 18 years post-hyst, is statically more likely to be going through menopause than she is to be pregnant.

and if you bothered to read my posts you would see that I have already said that it is more likely that her symptoms are menopause or delusional related but that pregnancy, while unlikely isn't impossible.

I was asked to post information related to pregnancy not contained within a uterus and of the rare (but yes very possible - ie real) occurences of pregnancy where the woman doesn't have a uterus.

I have several case studies but they are on an old hard drive and I need to go find the drive (which I haven't used in over 12 months) and haven't had time to find because I work a full time job, have a relationship and a life, and look after several forums of various backgrounds as well.

If you bothered to read you would see I had said I was not defending joanna, that I was still on the fence purely because I can not knowledgeably rule out the chance of a pregnancy, and that this was for general background information not a case study to convince anyone either way on joanna's case, but to simply disprove the myth that hysterectomy is always the end of a womans fertility and to show people what a hyst really is.

notafan

replied on April 20th, 2006

Experienced User

Re: Hysterectomy Fertilisation Pregnancy

kia_breizzze wrote:

and if you bothered to read my posts

frankly, I skimmed it, because I am familiar with the material. I simply take issue with you stating that pregnancy after hysterectomy is "very very" possible, when in reality the odds are vanishingly miniscule, and that a women without a uterus is still considered fertile. If this were so, why aren't doctors putting them on birth control afterwards?

Infertility is defined as the inability to conceive and/or bear children by natural means.

A women without a uterus is infertile.

Kia

replied on April 20th, 2006

Moderator

Re: Hysterectomy Fertilisation Pregnancy

notafan wrote:

a women without a uterus is infertile.

no, she quite simply isn't. A woman without ovaries is infertile but hysterectomy does not remove the ovaries.
Yes, sometimes the ovaries are removed at the same time as a hyst but they are not part of the same operation.
You evidentally are not familiar with the material, else you would know this.

Sunflower_pie81

replied on April 20th, 2006

Extremely eHealthy

A total hysterectomy removes the overies as well at the uterus.

Mabel

replied on April 20th, 2006

Moderator

I'm Going to Turn This Forum Around And Take You Two Home!

Let's just, for giggles and fits, say that in some weird tubesock world, this person did get pregnant without a uterus. Mmkay? Can we do that?

Ok, so there is a pregnancy now and what would be the likelihood of going nearly three weeks post term? Or even that a pregnancy would go this long without being noticed by anyone even remotely medically trained? -- i'm not talking the girl at the grocer store asking when your baby is due because you are fat, I mean an actual medical doctor who told you to take vitamins and come back next month so he can weigh you and take more of your urine and blood. Yeah, none of these things happened.

This is what the confusion is, kia. If there were feelings of a pregnancy, what in .God's name does anyone have any business believing that the baby (remember it is only one now) could still exist? Ok, pregnancy was *possible* we get that. what about now?

fatfamily02

replied on April 20th, 2006

Extremely eHealthy

She has said many times-----she is not defending me. She is just stating the fact that abdominal or ectopic pregnancy is possible after hysterectomy.

Why cant you just let it go? What is your obsession????? You come over here just to talk crap on me---more than anyone else has ever said about me. Why cant you just drop it????

I am pregnant, I have either one or 2 babies in my abdomen. I do not know!! So what if they are late? I was late with all my children.

I know of a christian woman who carried her baby for 12 months!! .God is .God and .He is the one in control--whether we recognize that or not.

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