Partial hysterectomy and pregnancy

Can I Have a Baby Post-Hysterectomy?

I’ve had a hysterectomy but I still have my ovaries. Is it possible for me to have eggs harvested and have a baby by a surrogate? What are my options if I want to have a baby?

— Julie, California

Yes, it is definitely possible to have a biological child (one that is genetically your own) post-hysterectomy if you still have your ovaries. There’s only one option, though: You must undergo drug treatment to stimulate egg production for one to two weeks, after which time the eggs can be harvested. The eggs are removed in a minor surgical procedure under anesthesia and then fertilized with your partner’s sperm in vitro (meaning outside the body, in the laboratory). The resulting embryo is then implanted in a surrogate.

Most states allow surrogacy, but it’s important to double-check with an experienced adoption and surrogacy lawyer first. Other options for having a baby include fertilizing donor eggs with your partner’s sperm (but such a baby is not biologically your own) or adoption.

Learn more in the Everyday Health Pregnancy Center.

Q. I am fairly certain that contraception will not be necessary after a hysterectomy but, given that the ovaries remain, I would like to know that ectopic pregnancy would be unlikely to occur in the future as well.

A. An ectopic pregnancy is one which occurs outside the uterus and are always life threatening. If they have been removed, along with the ovaries then this is not possible. If they remain and the ovaries are still functioning then there is a small risk of an ectopic pregnancy occurring. In most cases where the cervix is removed the vagina will be stitched at the top. This means that semen should be contained within the vaginal area. If the cervix is left in-situ then it is stitched at the point at which the uterus is removed.

However, according to the medical literature, there have been 56 reported cases of an ectopic pregnancy post hysterectomy; to put this into perspective, roughly 55,000 women have a hysterectomy in the UK every year so it is incredibly rare, probably a million to one chance!

It happens if the stitching is not complete or there is a tear. If this is the case and you happen to have an ovulated ovum (egg) in your abdomen at the same time as a sperm gets through then there is a slim change the two may meet. As I said though, it is very rare indeed though and will never result in a full-term pregnancy.

Ectopic pregnancy immediately after a hysterectomy is slightly more common (only slightly, remember there have only ever been 56 reported cases!). It is thought to be due to the presence of a fertilised egg before the hysterectomy took place which then implants on one of the other abdominal organs. Again this is a life threatening condition and will not result in a full term pregnancy.

If you are experiencing acute abdominal pain post-hysterectomy you should be scanned to make sure this isn’t the cause of their problems and to identify any potential tears in the stitching or vaginal cuff. Other reasons for acute abdominal pain can include

Ref: http://www.hindawi.com/journals/criog/2013/975196/

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Having a Baby After Endometriosis and a Hysterectomy

Facing Endometriosis and a Hysterectomy

Karen had a very fertile history. Her first two children, now both young adults, were conceived easily in her 20s. But after her pregnancies, she was diagnosed with endometriosis.

A painful chronic disease, endometriosis is one of the most common causes of infertility.

Each month, endometrial lining found inside the uterus sheds from the body during a woman’s period. When endometrial tissue grows outside the uterus or in other places of the body, it is known as endometriosis. As it does in the uterus during menstruation, endometrial tissue breaks down and sheds in other parts of the body, causing inflammation and pain. There is no known cure for endometriosis, but symptoms cease when menstruation ends.

To eliminate the pain from her life, Karen elected to have a hysterectomy at 40 years old to remove her uterus.

Finding Love Again

When her marriage ended and she became a single mother, she found support in her longtime friend Jim. They had been friends for over a decade, and found themselves ending their respective relationships at the same time. Without even realizing it, over time they found themselves romantically tied.

Jim had always wanted children, and Karen knew firsthand the love and joy that children bring. They hoped to share in the gift of parenthood together.

Without a uterus, they knew they would need a gestational carrier.

Since Karen was now 42 years old, the chances of a healthy egg supply were unknown. Working with Dr. Joseph Osheroff at Shady Grove Fertility Center, Karen underwent egg retrieval. They planned to combine Jim’s sperm with Karen’s eggs through IVF, then transfer the embryos to the uterus of a gestational carrier.

Dr. Osheroff was hopeful when Karen’s eggs produced good quality embryos for transfer. They transferred embryos to the gestational carrier, and learned that she was pregnant. Unfortunately, the pregnancy did not progress and the gestational carrier miscarried.

The miscarriage was incredibly painful for Karen and Jim. The loss also forced them to step back and reconsider their course of action.

Deciding to Use Donor Eggs

Due to Karen’s advanced reproductive age, using her eggs gave them a decreased
chance for a successful pregnancy and an increased chance of another
miscarriage. Karen and Jim were faced with a difficult decision – use Karen’s eggs or use an egg donor.

The choice was emotional and challenging, but after taking some time to reflect, they both decided the risks outweighed the benefits. They would conceive their child using donor egg.

When they told Dr. Osheroff of their decision, they were pleasantly surprised when he gave them a hug and shared the most hopeful words they had heard yet.

“Congrats, you are going to have a baby.”

Women over 40 have a five percent chance of pregnancy during any given month with natural conception. Doing IVF with frozen donor egg offers women a 45 percent pregnancy success rate at the age of 40.

After contacting Donor Egg Bank and reviewing donor profiles, they found themselves with a wide range of questions. They toiled over profiles, and considered their options.

Then Karen turned the tables in her mind.

If she was an egg donor and put her history down on paper, would she pick herself?

No.

Karen and Jim decided that they ultimately wanted a baby, and rather than get bogged down with endless questions, they wanted to move forward. They decided on a donor who looked similar to Jim, and shared his Hungarian and Polish features.

Within three days of finalizing a donor with Donor Egg Bank, Dr. Osheroff had received eggs for treatment. The gestational carrier was prepared for her cycle as the frozen donor eggs were fertilized with Jim’s sperm. Dr. Osheroff recommended that they transfer one embryo to the gestational carrier. The embryo was transferred on December 3rd, and they were overjoyed to learn they were pregnant two weeks later.

Bringing Home Baby

Karen and Jim reside in Maryland, while their gestational carrier lived in Colorado. They were diligent in traveling out for every other doctor appointment. When they found out they were having a baby boy, they were even more excited. Jim was the last male in his family, and now his family name would be carried on.

Nine months later on August 15th, their son James Vincent III was born.

“In the stages of choosing an egg donor I wondered in that moment how I would feel. There is absolutely no difference,” explains Karen. “I feel the same way for Jimmy as I do my biological children.”

When Karen and Jim walk Jimmy in his stroller, they are regularly stopped by strangers noting how similar Jimmy looks to his mother. Jimmy also has a birthmark on the back of his head, a unique family trait that Karen, her children and her mother were also born with.

Karen doesn’t understand how Jimmy came to look like her or have her family birthmark, but she believes it is God’s way of telling her that Jimmy belongs with her.

Karen and Jim are grateful for the joy of life, and the opportunity to see life through Jimmy’s eyes. They are quick to state that they became parents in a different way, but it doesn’t take away from the wonderful gift they now have.

Want more inspirational success stories?

Continue reading donor egg experiences here!

Becoming a Parent After a Hysterectomy

Becoming a Parent After a Hysterectomy: What It Is, How It’s Performed & Options To Complete Your Family Through Surrogacy

The inability to carry a pregnancy is devasting to many.

There are many medical reasons why a woman may need or choose to have a hysterectomy, but this procedure does not come without its consequences. If she wishes to still have children following a hysterectomy this may be an extremely painful decision.

For those who may need a hysterectomy rest assured there are still options available for you to complete your family.

First, let’s discuss what is a hysterectomy?

What Is A Hysterectomy?

A hysterectomy is a surgical procedure in which the uterus is removed from the body. This is considered to be a full hysterectomy. There are also other surgical operations known as partial hysterectomies that can be chosen instead. For the full version, the uterus is entirely removed and the fallopian tubes and ovary remain.

The uterus is an essential part of pregnancy. It’s located between the bladder and rectum and helps carry the baby once it has been conceived. The baby is placed within the lining of the uterus and is nourished there. A healthy uterus is what promotes a healthy pregnancy.

When this is removed, a woman no longer experiences menstrual periods. She typically cannot become pregnant either. For women who have had an entire hysterectomy performed, if she desires to have children again, then she has to utilize the services of a surrogacy agency in California or search for “surrogacy near me” if they are not in California.

Partial hysterectomies, or supracervical hysterectomies, only remove the upper part of the uterus. The cervix still remains. Sometimes the ovaries are also kept. Essentially, only the tubes and the rest of the upper part of the uterus are removed.

How is a Hysterectomy Performed?

There are different methods for a hysterectomy. In some cases, the uterus is removed through the lower abdomen thanks to a small incision. In other cases, the uterus is removed through the vagina. A laparoscopic technique is also possible in which the uterus is removed through many small incisions that are made in the abdominal area.

Determining which method is best is usually based on the size of the uterus. Sometimes it’s not possible to pull the uterus through the vagina or through the abdomen. Each method has its benefits and its share of risks. For those who have a large uterus or one that has a lot of scarring, then abdominal hysterectomies are usually the doctor’s first choice. It allows them to have a lot more flexibility.

Typically, it can take one to two hours for the surgery to be performed.

Vaginal hysterectomies are perhaps the easiest surgery to recover from. It’s minimal in its impact because the uterus is being removed through the vagina. For those women who have a small uterus, then they might be able to opt for a vaginal hysterectomy. There are fewer complications and the recovery time is reduced.

However, this surgery also takes about one to two hours to complete.

Reasons to Get a Hysterectomy

While many women choose to have a hysterectomy to ensure that they don’t have children, that isn’t the only reason.

For women who do have a hysterectomy performed or are infertile for other reasons, it’s still possible to have a baby of their own as long as they have the ability to harvest their own eggs. To be able to have a biological child, individuals will need the assistance of a surrogate to carry a baby.

Besides limiting fertility, there are medical reasons why a woman might choose or need a hysterectomy. Some women suffer from uterine fibroids. These are non-cancerous growths in the uterus that can cause a woman a great deal of pain. Even though they’re non-cancerous, some women may choose to have a hysterectomy because the pain is unbearable.

Another reason that women may choose to have a full or partial surgery is because of endometriosis.

This is when lining from the uterus grows outside of it. It can block the fallopian tubes and cause other problems. Endometriosis can also cause a lot of pain. This pain can grow in intensity during menstrual periods. It can also cause heavy bleeding, constipation, nausea, and lower back pain. Removal of the uterus can alleviate symptoms of endometriosis.

If you suffer from abnormal uterine bleeding, then you might also consider having a hysterectomy–either in full or partial. This condition occurs when you have extremely heavy bleeding during a menstrual period. You may even bleed or spot during or after sex. Your menstrual cycles may stretch to 38 days. Or they might even shorten to 24 days. This can sometimes occur due to benign growths that have grown in the uterus.

Adenomyosis is another condition that hysterectomies can cure.

It’s similar to endometriosis in that the lining of the uterus grows somewhere it’s not supposed to within the uterus. This tissue continues to harden and grow, especially during menstrual cycles. It can sometimes enlargen your uterus and make your menstrual periods extremely painful and heavy.

One last reason that women may choose to have a hysterectomy performed is to combat cancer.

Endometrial cancer and ovarian cancer are the two main types of cancer that hysterectomies can remove. It can also be used to treat early-stage cervical cancer.

Clearly, there are many reasons why a woman might need a hysterectomy. For those who have had a hysterectomy and would like to have a child of their own will need the use of a gestational surrogate to assist them. If you are interested in growing your family through surrogacy contact us and we will help you get started.

The Process of Surrogacy

We have heard many stories and seen many parents who have experienced the devasting loss of their reproductive abilities to carry a baby due to a hysterectomy.

If you still wish to have a child of your own but have suffered this loss, Made in the USA Surrogacy is there to help. If you still have the use of your ovaries you may be able to harvest your own eggs via IVF and create embryos that will then be transferred into your surrogate. Alternatively, if you do not have your ovaries or a healthy reserve of eggs, you have options to seek an egg donor.

If you’re thinking of growing your family through a surrogate and you’ve had a hysterectomy, then you have come to the right place.

First, you need to find a surrogate agency. Our surrogacy agency in California, Made in the USA Surrogacy, has quite a few surrogacy qualifications for your surrogate to meet before she is accepted as a surrogate. These qualifications are to ensure a healthy pregnancy for both the baby and the surrogate.

Some, though not all, of these surrogacy qualifications, include:

  • At Least One Prior Successful Pregnancy
  • Only One C-Section (preferably none)
  • Non-Smoker and Not In The Presence Of Secondhand Smoke
  • No Criminal Background

You can find the full list of our qualifications on our website. We will ensure your surrogate is a healthy candidate, suitable to carry your baby.

If you would like to complete your family through surrogacy please complete this form. If you are a woman who would like to help another family overcome these obstacles by becoming their surrogate, please apply today.

Can I Donate Eggs After a Hysterectomy?

It would seem logical that, if a woman’s uterus has been removed, she is no longer able to have children. And while that’s technically true, from a purely physical perspective, women who have had a hysterectomy are often capable of having children, even genetically – it just requires some extra help.

What is a hysterectomy?

A hysterectomy is the surgical removal of the uterus. The decision to have the procedure is never an easy one – and sometimes it’s not a choice at all. Whether it’s due to severe pain or a cancer diagnosis, this major surgery is likely to be thoroughly researched before a final call is made.

Sometimes, in the case of a severe infection or excessive bleeding after childbirth – for example, if the uterus won’t contract and the mother could die from the blood loss – an emergency hysterectomy may be performed. Typically, women with severe uterine fibroids, endometriosis (where the tissue that normally lines the uterus grows outside on the ovaries) or adenomyosis (where the tissue grows inside of the uterus where it doesn’t belong) are candidates for hysterectomy, as are women who have been diagnosed with cancer of the uterus, ovary, cervix, or endometrium (uterine lining).

There are three main kinds of hysterectomies:

  • A supracervical or subtotal hysterectomy, where only the upper part of the uterus is removed and the cervix stays in place

  • A total hysterectomy, where the whole uterus and cervix are removed

  • A radical hysterectomy, where the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina are removed

Do ovaries release eggs after hysterectomy?

As long as the ovaries remain intact, they will continue to function. Depending on your risk, they may be removed during the hysterectomy in a procedure called oophorectomy to lower the risk for ovarian cancer. According to the Office on Women’s Health, however, “recent studies suggest that removing only the fallopian tubes but keeping the ovaries may help lower the risk for the most common type of ovarian cancer, which is believed to start in the fallopian tubes.” The decision to keep your ovaries is a discussion for you and your doctor, but it’s generally recommended unless removal is absolutely necessary.

Can I donate eggs after a hysterectomy?

Yes, it is possible to have an egg retrieval after a hysterectomy. While you would likely not qualify as an egg donor for someone else, your fertility clinic can explore options with you for your own IVF cycle. Your antral follicle count, or ovarian volume, would be checked to judge the likelihood of a successful retrieval. You would have an ovarian ultrasound to determine the condition and location of your ovaries, as they sometimes move after a hysterectomy. Your hormone levels would also be monitored to determine where you are in your cycle so that the egg stimulation and retrieval can be appropriately scheduled.

If it is ultimately decided that your ovaries need to be removed during the hysterectomy, you can explore the option of harvesting your eggs first. It will likely depend on your age – just as you are not able to donate eggs at 40 or later, you’ll want to consider the quality of any eggs retrieved. If they are healthy, they can either be frozen for a later attempt at fertilization, or they can be fertilized right away with your partner or a donor’s sperm. The embryos can then be frozen until you’re ready to attempt IVF with a gestational carrier.

Surrogacy after hysterectomy

When you decide to build a family, it’s time to team up with an agency to start your surrogacy journey. A gestational carrier will undergo IVF – using either the eggs that you harvested and froze for later fertilization, frozen embryos, or perhaps embryos created with the help of an egg donor. A hysterectomy is a difficult decision and one that may require a great deal of healing, both physically and emotionally. We are here to support you when you’re ready and will walk with you through the process, step by step.

Getting Pregnant After a Hysterectomy

Can I Get Pregnant After A Hysterectomy?

The answer to this question is riddled with other questions. What is the definition of a hysterectomy? Can a woman carry a child with no uterus? Can somebody else carry a child for her if she has no uterus?

A total hysterectomy is the removal of the woman’s uterus and cervix. A partial or subotal hysterectomy involves removal of the uterus only and not the cervix. If the ovaries are also removed then that is an additional concern. Depending on the type of hysterectomy the woman has undergone, and especially if one or both ovaries are still in place, there may be some chance left that an egg can be released and fertilized by a sperm.

No Uterus/No Normal Pregnancy

If a female has had her uterus removed, if she had a total or partial hysterectomy, then there is a close to 0% chance that she can deliver a baby from her own body.

Ectopic Pregnancy

There is, however, a minute chance that during the ovulation process, the egg will be released and fertilized by a sperm. These very rare cases of pregnancy after a hysterectomy are so-called “ectopic pregnancies”, where the fertilized egg will attach to the abdominal wall, or some other organ such as the bowel, bladder, ovary, or even the liver. This will not result in a live birth and can, in fact, be life threatening. If the fetus finds a blood supply sufficient to maintain growth for the first few weeks, it may grow further. The pregnancy may rupture and there could be severe bleeding which can only be stopped by surgery. Detecting this type of pregnancy is not always easy. Abdominal pain and bleeding may lead a woman to the doctor where the pregnancy will need to surgically removed to save her life.

One Ovary/One Fallopian Tube Removed

However, if the woman has had one ovary or one fallopian tube removed and the uterus remains intact, there is a great chance that she will become pregnant in the future. Only one ovary and one fallopian tube is needed to release an egg to be fertilized. While this form of ovary removal is normally not defined as a true hysterectomy, many women feel the removal of an ovary or fallopian tube could be considered a hysterectomy.

Total Removal Of The Ovaries And Fallopian Tubes

The female who has both of her ovaries and fallopian tubes removed may or may not also have had the uterus removed as well. When this procedure is done, known as a total hysterectomy with bilateral oophorectomy, there is no chance of getting pregnant. The cervix is most often removed along with the other female organs and the upper end of the vagina is closed with sutures. The result is surgical menopause and there is no place for the sperm to go, let alone any eggs left to fertilize.

Surrogacy

There is a way for woman who had a uterus removed to have a baby, though somebody else has to carry it for her (surrogate). This can only happen if she has one or both ovaries left. Eggs can be removed, fertilized outside the body, and a surrogate can then become pregnant and carry the baby.

Getting Pregnant During Menopause

How Much Do Egg Freezing and IVF Actually Cost?

A year ago, after her divorce, Kaye froze her eggs. Recently, Sadie and her partner began the in vitro fertilization (IVF) process. In addition to being emotionally and physically arduous, both of these procedures come with a hefty price tag, and they’re not always covered by insurance. Women ask us all the time: “Should I look into a fertility treatment?” And our answer is always the same: Check in with yourself first — your hormones, your finances, your emotional state. It’s a big decision and today, with help from three women who’ve gone through it, we’re digging into the money piece. How much do egg freezing and IVF actually cost?

Kaye’s egg freezing journey

Egg freezing is a method of fertility preservation. After taking ovarian stimulating medication (AKA hormones that cause your ovaries to develop multiple eggs), the matured eggs inside your ovaries are retrieved, frozen, and stored until you choose to use them to conceive. If you decide to use them one day, the eggs are combined with sperm in a lab and implanted into your uterus through IVF — more on IVF in a bit. When Kaye, who lives in New Jersey, froze her eggs, her ultrasound, baseline blood tests, and follow up with her doctor added up to $925.

Here’s exactly how she arrived at this amount:

$200: For the ultrasound, which assesses your ovaries for anything that might be an issue (like ovarian cysts) and helps predict how many eggs might be available and robust enough for retrieval.
$200: For initial blood work. This looked at Kaye’s progesterone and estrogen levels. Both of these hormones are key for regulating the menstrual cycle.
$325: For additional blood work. Kaye was asked to come in on the third day of her period to accurately measure follicle stimulating hormone (FSH), which promotes the formation of eggs, and luteinizing hormone (LH), which triggers ovulation. Her anti mullerian hormone (AMH) levels were also measured, which determine how many eggs are left in her ovaries (AKA ovarian reserve). Understanding these hormone levels informs the treatment protocol and also helps potentially diagnose conditions like polycystic ovarian syndrome (PCOS).
$250: For the follow-up consultation with her doctor, after the ultrasound and tests, to discuss how to proceed given her results.

Now that we’re officially talking ca$h money, it’s important to note that this is a case study, as is the one below. All of these costs can vary greatly, which we’ll cover.

As you probably guessed, these initial appointments weren’t Kaye’s last. A single egg freezing cycle — yes, there are often multiple cycles so you can retrieve a sufficient number of eggs — is typically three weeks long. First, you have one to two weeks of taking hormonal birth control. This ensures your body’s natural hormones are turned off. Then, there are nine to 10 days of injecting yourself with synthetic hormones so your ovaries will mature multiple eggs (rather than just one, which is typical during ovulation). For Kaye, these injections were partially covered by insurance.

When the eggs are retrieved or harvested by a doctor, there’s a charge for anesthesia. The retrieval is an in-office procedure that takes about 20 minutes (for the retrieval itself — the entire process, including anesthesia, can take a couple of hours). The retrieval can cost anywhere from $600 to $1500. Then, there’s the matter of storing the eggs. Kaye’s storage fee is free for the first year, but $1200 for every year after.

$8,163: Total for Kaye’s first egg freezing cycle. This includes injections, anesthesia, and retrieval.
$5,150: Total for Kaye’s second egg freezing cycle, including all of the above. This time, she hit her insurance deductible, so insurance (which she has through her employer, who covers egg freezing) totally covered the cost of injections.

These are some big numbers. “I used the money from my divorce to pay for it,” says Kaye. “Half of our joint savings and half of our wedding gifts. I felt so guilty keeping money that people gave us to start our lives, so I used it to start my life again.”

Sadie and Eliza’s IVF journey

IVF is a process by which eggs, which have previously been extracted, are combined in a lab with retrieved sperm. Then, the resulting embryo is transferred to a uterus. Egg freezing can be the first stage of IVF. Meaning, if you choose to use your frozen eggs at a later date (some women end up conceiving naturally, so there’s no need to ever use their frozen eggs, you’ll go through the IVF process. This isn’t the only way IVF can go down, though — you can also use freshly harvested eggs for IVF if you want to become immediately pregnant. Meaning, the eggs are retrieved, immediately fertilized in a lab with sperm, and implanted in the uterus.

Bottom line: If you choose to freeze your eggs, don’t forget about the potential costs of IVF down the road. If you’re pursuing IVF, consider the costs of egg retrieval, too, since this is a required step in the process.

OK — back to Sadie and Eliza, a lesbian couple living in the D.C. area who are experiencing the IVF process right now. Because they’re a same-sex couple, their particular insurance won’t cover IVF for them (though some insurance companies will do this). They’re financing the entire pregnancy process themselves. There are only 15 states in the US that require insurance cover infertility costs. But here’s the thing: This doesn’t necessarily apply to all companies, like self-insured employers. The definition of “infertility” is also quite narrow. You have to be between 21 and 44, trying to get pregnant for one year via intercourse (in Sadie and Eliza’s case, you can see how this definition wouldn’t apply), or for six months if you’re over 35.

Sadie and Eliza are doing what’s known as “co IVF” or “reciprocal IVF.” In this procedure, Eliza underwent egg retrieval. So, like Kaye, she was given hormones to stimulate her ovaries into producing multiple eggs. Those eggs were combined with and fertilized by donor sperm. Then, Sadie received the embryo and will (hopefully) carry the pregnancy to term. Since Eliza’s eggs were fertilized while they were fresh (instead of frozen) Sadie’s uterine lining had to be prepped so it would be ready to house it, which is done through hormone medication.

Sadie and Eliza’s fertility clinic offers a shared risk option. This means all of the costs associated with IVF are covered, if all of this doesn’t result in a live birth. That’s right: They will get 100 percent of their money back if this process doesn’t result in a baby. Sadie and Eliza qualified for this program because they met certain criteria. For this particular clinic, a physician first had to sign off on IVF being medically necessary. Second, both Eliza and Sadie had to be 40 when the IVF was completed. Some clinics also require that a woman’s AMH be a certain level for the shared risk program. Upfront, this costs Sadie and Eliza $22,500. This includes up to six egg retrieval rounds (should they need that many) and as many embryo transfers as necessary.

$3,000: Eliza’s ovarian stimulating injections.
$22,500: Shared risk option IVF (includes Eliza’s egg retrieval and anesthesia, donor sperm — which can cost between $1,000 and $5,000, fertilization of Eliza’s egg, Sadie’s hormone medication, anesthesia for the transfer to Sadie’s uterus, and the actual transfer to Sadie’s uterus),
$25,500: Total cost

Sadie and Eliza are currently waiting to learn if their recent round of IVF was successful (meaning, if the embryo has actually implanted in Sadie’s uterus and pregnancy has been achieved). Because of this primary concern, they’re trying not to think about the money. “You already feel like your body has been abducted by an alien who may or may not exist,” says Sadie.

Your fertility journey

First thing’s first: Don’t panic. While all of these costs seem high, there are options for financing IVF and egg freezing. Sarah, who shared her egg freezing story with us, took out a new credit card with zero percent APR for 21 months. She pays off a little bit every month and thinks of it like a loan.

Desiree, who underwent two rounds of IVF in New York City, took out a private loan. There are also companies like Compassionate Care who provide loans to uninsured folks in a certain income bracket for IVF or other infertility treatments. Like Sadie and Eliza, Desiree and her partner also qualified for a shared risk program at their clinic. The shared risk option — as Sadie and Eliza opted for — is another possibility if a clinic has a similar program and you meet the program criteria. Most clinics have financial advisors on staff who guide you through the process and help determine the best option for you.

In terms of insurance, these resources from RESOLVE (The National Infertility Association) can help you untangle the details, like insurance coverage by state and coverage through work.

There are a lot of personal factors that can impact the cost of both IVF and egg freezing — the stories above are just examples. For instance, where you live — we love this piece from FertilityIQ that breaks down average cost depending on where you live. We even called eight fertility clinics in the San Francisco Bay Area to better understand cost diversity within a single region. Across the clinics, the initial consultation ranged from $225 to $1050. The cost of blood work ranged from about $800 to $1500. However, some clinics tested fewer hormones and sent patients to a third party lab for testing, in which case the cost of blood work was lower. These are all out-of-pocket costs, so they would be lower assuming your insurance or employer covers infertility.

Other factors influence price, too. Like, how many cycles do you want or need to go through? How many eggs do you need retrieve? Research shows that your AMH levels can tell you a lot about this. We already done the homework on this topic for you.

Last but not least: While this post is focused on the financial cost of IVF and egg freezing, it’s important to call out the emotional cost of these procedures. When considering your options, make sure you have support. Taking care of yourself — not just your wallet and bills — will ensure you can emotionally withstand the journey. At Modern Fertility, we’re right here with you, every step of the way, to help you navigate everything from money to mental health.

Years ago, my appendix ruptured, causing peritonitis and gangrene, leaving my fallopian tubes blocked with scar tissue. I have known for years this was almost certainly no bueno for future conceiving, but found out for certain last year when, before an operation, my surgeon offered to do a fertility test “while they were there”. They injected dye up through my womb to see if it came out both tubes. No dice. I am infertile. I’d have to consider IVF if I wanted to become pregnant, or egg and/or embryo freezing. So, after a year on the waiting list at my local NHS hospital, that’s what I did.

Earlier this month, the British Fertility Society suggested that every 25-year-old woman should be offered a “fertility MoT”. The BFS’s chairman, Prof Adam Balen, said: “There is a lack of understanding of the dramatic decline in fertility and, of course, there are pressures to develop careers. Every week in our clinics I see couples who express surprise because they didn’t realise the degree to which fertility goes down in your 30s.” There is no agreement yet on what such a “fertility MoT” might include (though there have been some suggestions) but the option of egg-freezing will almost certainly come into it.

Egg-freezing is a prevailing topic of conversation between women in their 20s and early 30s now, as we work out – and are reminded nearly every waking minute – how the sell-by-dates on our ovaries might fit in with our plans. We’re forced to imagine future versions of ourselves, holograms of life not yet lived. It’s strange, being in a bind with your own biology. But while getting a handle on what our options are earlier might be great in theory, Laura Bates was right last week when she argued that perhaps the reason Emily Bingham’s viral Facebook postresonated with so many women was “not only the constant stream of diktats about pregnancy, but also what isn’t spoken about”.

Though there are endless public discussions about baby-making, fertility is less talked about, apart from the usual “don’t leave it too late” warning. Describing what actually happens when you freeze your eggs is one of the things not widely heard about. As I injected my belly daily with hormones, I thought about this MoT thing and wondered how many 25-year-old women know what they actually have to put their body through to freeze their eggs? If we’re going to expand discussions about fertility, we need to be clear about what these things involve. It isn’t scare-mongering to be realistic.

The way egg-freezing is casually thrown around belies not just how hard it can be for a woman, but also how it comes with no guarantees. Right now, it feels like this giant crash mat we all think we’ll have to fall back on. Last year, when Facebook and Apple announced they were offering it as an employee perk, there were important arguments made about how, despite it being a move that appears to be offer choice, in continuing to hustle women into working to an age where it becomes much harder to have kids, it also says: do it later on, when you’ve earned it. Pregnancy is a rival to work that must be fenced off for corporate use. But where was the information about the process itself? About how some women go through it with no success and are faced with a big, scary, “now what?”

Egg-freezing – or embryo freezing, if you’re planning for the future with your partner or are using donor sperm – means doing a round of IVF, essentially, without the embryo transfer at the end. It can be expensive as well as gruelling – self-funded egg freezing at Kings College Hospital costs £2,500, then an additional £250 annual storage past 24 months. Depending on variables like your natural egg reserves (if they’re low, so are your chances) and follicle-stimulating hormone levels, you will be given a bespoke cocktail of hormones to ingest and inject over a number of weeks to do the following: stabilise your womb lining, stimulate your ovaries into producing several massive follicles, stop them releasing eggs (ovulating) and then, finally, with an ovulation trigger injection, “mature” the eggs to be collected under deep sedation or general anaesthetic.

It’s important to state that many women get along with the hormone medication fine and are able to carry on their day-to-day lives. But many aren’t. Every body is different. We’ve all heard horror stories about IVF, but that very process is what egg-freezing involves and there are things I wish I’d been more prepared for.

Seeing a counsellor is compulsory before you begin and the doctors and nurses gave me plenty of clinical information – a ring binder’s worth – but much of it was of the “most women find …” variety.

Honestly, though, I wish someone would have told me straight about how shit I might feel. I wish I’d known that some of the pills they put you on to maintain your womb lining contain huge amounts of oestrogen – the hormone that, when it surges in early pregnancy, causes morning sickness. I spent 10 days, my nurse said, effectively experiencing morning sickness. All I wanted to eat was cake and melon. A kind friend who had recently been through it all checked in every day, which was a godsend, but I do wish I hadn’t had to spend so much time in the queasy world of fertility forums (where women communicate through infantile acronyms about their DH’s – dear husbands – exchange “babydust” and refer to embryos as “embies”, something artist Polly Morgan wrote about brilliantly), looking for advice on whether I was supposed to feel my ovaries twitching when I started the injections.

I wish more had been written about how many times throughout the process you have to have the dildocam pushed between your legs in a room full of people, and how many times you have to watch the doctor militantly rolling a heavily lubed-up condom over it. (OK, that bit is funny.) All the terminology surrounding fertility is so farmyard-y – “harvest”, “fertilise”, “egg collection” – but no one really tells you how bovine you might actually feel. Then there’s the druggy, cartoonish tiredness. The tears. The potential mental health wobbles. The loneliness of an experience people don’t want to ask you about too much in case they think it should be private, when actually, you’re dying for someone to come round.

I wish I’d known about how painful the harvest can be. You’re knocked out while they introduce a thick needle through your vaginal wall and drain the follicles of their liquid, hopefully containing mature eggs, but when you come round you might not just experience “some cramping”, like the nurse warns. You might feel pain for the next week so deep it feels like your spine is growling. You might walk around like you’re trying to hold an aubergine inside your arse. I wish I’d know that the risk of ovarian hyperstimulation syndrome (OHSS), for which I was admitted to hospital, isn’t as rare as we’re lead to believe. In terms of egg production, I knew that quantity didn’t mean quality and that producing 18 eggs (“fabulous,” said the embryologist down the phone) might mean only two were mature enough in the end to use. But it doesn’t mean I didn’t feel sad when the number wasn’t as high as I’d hoped.

One person’s experience should never be considered an omen for your own, particularly with something like this, but if egg-freezing is going to become more commonplace, we must encourage transparent conversation about what it entails.

Question

When a woman has a hysterectomy that only takes away the womb, leaving the tubes and ovaries.

Wwhat happens to the eggs that are released during ovulation and where do they go?

Answer

The ovaries actually float in the space in the pelvis (pelvic cavity), in close proximity to the opening of the Fallopian tubes, which are attached to the womb (uterus).

The Fallopian tubes have a fringe of gently moving ‘cilia’ at the opening nearest to the ovary, which is known as a ‘fimbria’. The wafting of these tiny finger-like tissues encourages the movement of the released egg, or ova, in to the Fallopian tube.

They look rather like sea anemones, if that helps to imagine what the appearance of cilia is like.

If the fimbrae are no longer there, then any released eggs fall in to the pelvic cavity and are absorbed in to the surrounding tissues.

Ovaries can keep working for some time after a hysterectomy although the precise time is difficult to be sure of.

Although consultant gynaecologists would normally advise that normal ovarian function ceases either almost immediately or within the first year after surgery, some women do experience cyclical mood swings and other premenstrual symptoms for much longer than this.

With the usual method of removing the womb by a conventional hysterectomy (through a surgical cut just above the pubic area), the Fallopian tubes are usually removed along with the womb, but the ovaries or the cervix may be left intact.

With a vaginal hysterectomy (more usually performed in older women, particularly when associated with a prolapse), because of the way that the operation is performed, it is more likely that the fimbrial ends of the Fallopian tubes would be left behind.

For women unsure as to whether they have had their ovaries removed or not, it was much more common in operations performed more than five years ago to have the ovaries and Fallopian tubes removed (bilateral salpingo-oophorectomy) than ‘conservation of the ovaries’ (ovaries left behind).

It is usually detailed within the letter sent to the GP by the operating consultant exactly what operation has been carried out and if a woman is unsure as to the precise nature of her operation, then it is (usually) relatively easy to find out, by either speaking to her GP or checking with the hospital directly.

Yours sincerely

The NetDoctor Medical Team

Last updated 06.11.2013

What is going on in my body?
April 23, 2011 10:02 AM   Subscribe

First, how is ovulation still possible with no uterus? Where are the eggs even going?
It might help you to look at a picture of the female reproductive organs. The way your body works is that each month, an egg cell ripens in one ovary or the other and is pushed to the surface of the ovary. From there it is expelled into the fluid surrounding your ovary, basically just into your abdominal cavity. But as you can see in that picture, the tentacle-like fimbria of the fallopian tubes are very close to the ovaries, so the egg typically floats into the fallopian tubes and is moved slowly toward the uterus by tiny waving hair-like projections on the insides of the fallopian tubes. The egg may or may not get fertilized as it moves down through the fallopian tube — if yes, it will implant in the wall of the uterus and grow into a baby; if not, the egg will simply be lost along with menstrual fluid in the monthly period.
So, you had your uterus removed, obviously the egg can’t end up there. But you still ovulate the same way: one egg each month is expelled from an ovary. If you still have your fallopian tubes, it will probably still move into them as though there was a uterus at the other end to go to. It’s just that the other end of the fallopian tube is likely closed off, so the egg will simply be reabsorbed in time. (Surgery to remove fallopian tubes usually includes the prefix “salpingo-“, I’m not sure whether they would have removed yours or not with a partial hysterectomy.) If you don’t have your fallopian tubes anymore, the egg just floats around in your abdominal cavity until it is broken down and reabsorbed.
I can’t speak to the harvesting and surrogate issue, but that is a great question for your doctor. He or she will not think that’s a dumb question at all.
posted by vytae at 1:42 PM on April 23, 2011

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