Advertising on the portal

Ovulation after ovarian resection. Ovarian resection: surgery and recovery

But what if, shortly before the planned pregnancy, one of the future parents underwent surgical intervention? How long until the next one? pregnancy after surgery. How quickly will the body recover after taking antibiotics or other serious therapy?

It would seem obvious that such questions should be addressed directly to the doctor. However, often future parents prefer to look for information “among the people” - from friends, acquaintances or on the Internet. Unfortunately, in this case, instead of an adequate answer to the question, there is a high risk of running into all sorts of “folk wisdom” - various myths and prejudices related to the topic of “planning pregnancy after...”.

  • After any surgery You have to wait at least a year!

This categorical statement can only be heard from a person who is absolutely ignorant of medical issues. Surgery- this is not a disease, not a diagnosis, but only a designation (and a very general one!) of the type of medical intervention in which surgical dissection of tissue is performed. For example, surgical intervention is equally the removal of an inflamed appendix and the opening of a boil by a surgeon in a clinic. It is obvious that these surgical interventions have completely different effects on health and, accordingly, recommendations for family planning in the postoperative period will also clearly differ!

Surgical operations there are large and small, planned and emergency, abdominal (i.e. with penetration into the abdominal cavity), multi-stage (when one operation is divided into several successive stages with an interval of several minutes, days or even months), plastic, cosmetic and many more other types. After some interventions, it may take many years to restore function, while after others, a couple of hours or days are enough. Moreover, there are surgical interventions performed as part of the treatment of infertility - for example, restoration of the patency of the fallopian tubes, removal of ovarian cysts or venoplasty for varicoceles (varicose veins of the testicles), after which it is recommended to begin trying to conceive in the next cycle!

Operations are divided by area and volume of intervention, as well as by indications for intervention; the period required for a person to fully restore health before planning a conception depends on this, as well as on the course of the operation and the postoperative period. Necessary planning recommendations pregnancy after surgery can be obtained from the doctor who performed the operation and observation in the postoperative period. If this is not possible (for example, because it has been a long time or due to moving to another city), you should discuss the issue of planned conception with a family planning specialist, providing him with a discharge postoperative epicrisis (a medical report given to the patient upon discharge after surgery).

  • Plan pregnancy after surgery It is possible only a couple of months after any treatment.

This statement is no less baseless than the previous one, but also harmful! The myth is based on the belief that all medications are harmful to the child, therefore before conception Any previously taken medications should be discontinued immediately. Such “folk wisdom” is not only incorrect, but also dangerous - following it, you can jeopardize the very fact of pregnancy and the health of the unborn child. If before pregnancy one of the expectant parents was constantly taking certain medications, it means that he has chronic diseases that require treatment. Moreover, sometimes such treatment is required constantly, for example, with bronchial asthma, eczema or arterial hypertension (tendency to increase blood pressure). At the same time, planning a conception for such a chronic patient may not be contraindicated at all, and drug therapy is precisely necessary for the successful onset and course of pregnancy. In this case, unauthorized withdrawal of drugs can cause an exacerbation of chronic pathology and lead to a general deterioration in the health of future parents.

The exacerbation of the disease after sudden cessation of treatment is also facilitated by a general decrease in immunity in the case of pregnancy. It is especially dangerous to unauthorizedly cancel medications that correct blood pressure, heart function, lungs, kidneys and liver, as well as medications prescribed by an endocrinologist (treatment of diabetes mellitus, diseases of the adrenal glands, thyroid and pancreas, etc.).

The course of pregnancy and the development of the baby directly depends on the condition pregnant woman's health. During pregnancy, the mother's body has a double burden; medications prescribed by a doctor for the treatment of chronic diseases help the expectant mother cope with the increased workload and safely bear the baby. Therefore, voluntarily cancel therapy prescribed by a doctor before pregnancy, under no circumstances should. If you have chronic diseases, it is worth discussing in advance, at the stage of pregnancy planning, with your doctor the possibility of taking certain medications before conception and in the first days of pregnancy. And at the first sign of an “interesting situation,” visit a specialist again to adjust the therapy and dosage of medications in connection with the onset of pregnancy. The doctor will replace some medications with analogues that are not dangerous for mother and baby, and the dosage of some medications will be gradually reduced. It is possible that the doctor will be forced to discontinue some medications in the interests of the fetus. However, only a specialist can decide to cancel, replace or reduce the dose of a previously prescribed drug; unauthorized withdrawal of medications can affect the health of the mother and fetus much worse than taking the most “harmful” drugs.

The same goes for planning. pregnancy after taking antibiotics– each antibacterial drug has its own period of accumulation and elimination from the body, its own level of harmfulness with a potential effect on conception. There are antibiotics that do not cause significant harm to the germ cells, embryo and fetus. If necessary, they can even be prescribed during pregnancy. When taking such antibiotics, the interval before the planned conception is determined only on the basis of the recovery time of the body and microflora (after treatment with any antibacterial drugs, it is necessary to restore the normal flora of the intestines and genital tract). Other drugs in this group have a pronounced teratogenic (damaging to the fetus) or toxic effect; their half-life products can remain in the blood for a long time, and recovery after administration sometimes takes up to six months or even a year. The conclusion is obvious - the issue of timing of conception planning after any drug therapy can only be decided with the attending physician. When determining the timing, the doctor will take into account not only the fact of taking a particular drug, but also the frequency, duration and dosage of the drug, the reasons for the treatment, the individual characteristics of the effect of taking the drug on the body and the general state of health after the end of therapy.

  • You can't get pregnant immediately after discontinuation of oral contraceptives.

A completely false statement. There are different types of hormonal drugs in this group. Some drugs are based on suppressing egg ovulation, others affect the viscosity of cervical mucus (mucous secretion that fills the lumen of the cervix), others inhibit the growth of the endometrium - the mucous membrane of the uterus, the thickness of which determines the possibility of implantation (attachment) of the fertilized egg. Most modern oral contraceptives are combined, i.e. combine different types of hormones and provide a comprehensive contraceptive effect. However, regardless of the type of exposure, these drugs affect the body only directly during regular use: when any of these drugs are discontinued, menstruation should begin, followed by a normal menstrual cycle with full maturation of the egg, growth of the endometrium and permeability of cervical mucus. Thus, after finishing taking oral contraceptives, there is no after-effect (for example, accumulation of harmful substances in the blood or pathological changes in the functioning of the organs of the reproductive system) that could represent danger to pregnancy. Moreover, drugs in this group are effectively used to treat various types of hormonal infertility. In some cases, the use of oral contraceptives continues after pregnancy - during the first trimester, drugs containing PROGESTERONE are prescribed to prevent and treat the threat of miscarriage in the early stages.

  • Can plan a pregnancy immediately after removal of the IUD.

And in this case, everything is exactly the opposite. The advice is again wrong. IUD, or intrauterine device– a “female” method of contraception, to achieve which a special spiral made of medical steel coated with silver, gold or even platinum is inserted into the uterine cavity for a long time (1 year, 3 years, 5 years) (precious metals are used to prevent purulent inflammation). The contraceptive effect is based on the rejection reaction, which is provoked by a foreign body (coil) located in the uterus.

During the entire period of wearing the IUD, a process of aseptic (non-purulent) inflammation occurs in the uterus, the tone of the uterus increases, the structure of the endometrium (the mucous membrane of the uterine cavity) partly changes - these are the factors that prevent the implantation of a fertilized egg in the uterus. Some IUDs are equipped with a capsule containing a hormonal contraceptive, which is constantly released in the woman’s body while wearing the IUD, but the main effect of this method is still based on inflammatory provocation in the uterus. In this regard, gynecologists do not recommend planning conception earlier than 3 months after removal of the IUD - it is necessary that the consequences of prolonged aseptic inflammation in the uterine cavity are completely eliminated. Otherwise, upon conception, the risk of developing a threatened miscarriage or even an ectopic pregnancy increases significantly. The couple is recommended to use barrier methods of contraception (condoms, vaginal membrane, cervical cap) for 3 months, and before the planned conception, consult a gynecologist again for a re-examination, collection of tests and a control ultrasound to confirm the completion of restoration processes in the uterus.

  • After unsuccessful pregnancy Long-term treatment is always necessary.

This statement is erroneous due to its categorical nature: long-term treatment after termination of pregnancy may indeed be necessary, but not always. The term unsuccessful pregnancy includes all options in which pregnancy did not take place. There are many such options, and they differ greatly from each other in terms of the reasons for their development, course, completion and consequences for the health of the expectant mother. “Unsuccessful” options include spontaneous termination of pregnancy (miscarriage), non-developing or “frozen” pregnancy, when the growth of the embryo stops at any stage of development, ectopic pregnancy, artificial termination (abortion) or stimulation of premature labor for medical reasons (fetal pathology, incompatible with life). Recommendations for the timing of planning a second pregnancy in each of the listed cases will vary significantly. For example, after a spontaneous miscarriage due to hormonal deficiency, you can plan the next pregnancy after 3 months (provided there are no other pathologies and progesterone medications are prescribed), and in the case of an ectopic pregnancy, treatment and restoration of the body may take several years. The only thing that is the same for all cases of planning a second pregnancy after an “unsuccessful” one is the need for a thorough medical examination, which will help identify the causes of failure and avoid it in the future.

  • Between births– no less than 3 years!

This slogan also cannot be considered an axiom. The time required for an expectant mother to recuperate after a previous birth is very individual. Some are ready to experience motherhood again 1–1.5 years after the previous birth, others – a couple of months after the end of lactation; For others, even 3 years may not be enough to fully restore strength and health. Planning Guidelines next pregnancy are very individual and are given by the doctor taking into account many factors. It is necessary to take into account the course of the previous pregnancy, childbirth and the postpartum period, the duration and duration of lactation, the general state of health and the age of the patient. For example, it is difficult to imagine that a doctor would recommend that a healthy patient who successfully carried and gave birth to her first child at 38 years old should wait strictly 3 years before planning her next child - after all, after 40 years, the likelihood of pregnancy decreases! In this case, as in all other options for planning conception, taking into account health conditions, it is necessary to turn not to “folk wisdom” of dubious origin, but to doctors.

  • in the reproductive sphere it is impossible to plan earlier than in 5 years.

The history of the emergence of such a myth (it should be noted that it is very persistent!) is quite clear: this is exactly the “waiting period” that doctors recommended after operations on the uterus, primarily after a caesarean section, several decades ago. Such an impressive gap between the surgical intervention and the planned pregnancy was explained by the time required for the complete resorption of the suture material used at that time, the formation of stable scars at the site of the incisions, and the duration of recovery of the woman’s body after a severe, traumatic operation. However, since then, much has changed for the better in medicine and surgical technology: operations have become much less traumatic (for example, extracorporeal caesarean section with a vertical incision along the entire abdomen is now practically not used), modern suture material is absorbed within a few weeks, postoperative scars due to with this they became much more elastic (this significantly reduced the risk of rupture of the uterine scar during subsequent pregnancy and childbirth), the formation of a stable postoperative scar is completed on average 1 year after the operation.

Many gynecological and urological interventions are now carried out endoscopically (through the vagina and uterine cavity), endovascularly (intravascular technique) or laparoscopically (through micropunctures), which allows minimizing traumatic consequences for the body and significantly reducing the time required for complete restoration of health before planned conception. Therefore, today, to the question “When can you plan pregnancy after cesarean? parents can hear the doctor’s joyful answer: “Yes, come back in a couple of years!” After some purely “male” and “female” operations performed to increase the chances of conception - for example, treating varicose veins and hydrocele in men, blowing out the fallopian tubes and removing foci of endometriosis in women (benign growths of the endometrium outside the uterus) - plan Conception is possible already after 2 months, and sometimes almost immediately after discharge. Of course, in each specific case, recommendations for a couple will be purely individual: the type of intervention, indications, volume and characteristics of the operation and postoperative period, as well as the age and general health of the future parent who underwent surgical intervention in the reproductive area, matter.

Having children is a unique ability of the female body. Some diseases of the genital organs lead to reproductive dysfunction and require surgical treatment. Why ovarian resection is performed, how it affects the body and whether pregnancy is possible after it, you will learn from the article.

Every month, one or more follicles are formed in the ovaries, each of which contains a mature egg ready for fertilization. In addition, the ovaries synthesize female sex hormones, which affect all types of metabolism and the emotional state of a woman. For various reasons, tumors, cysts and other diseases arise in them, the treatment of which is only possible through surgery.

Complete removal of the gonad leads to hormonal imbalance, early menopause, and infertility. Ovarian resection - what is it? This is the surgical removal of only part of an organ, which helps preserve the woman’s health and her ability to conceive a child.

Methods and indications for use

The attending physician determines the type and extent of the upcoming operation based on the patient’s age, her state of health and the severity of the disease. Resection is indicated for:

  • confirmed benign tumors;
  • injuries.

Resection is performed using one of the following methods:

    • laparoscopic - minimally invasive intervention, access is made through 3-4 small incisions. Along them, manipulators are inserted into the abdominal cavity, through which the surgeon performs the operation;
    • laparotomy - full abdominal surgery, access through a midline incision in the anterior abdominal wall.

The essence of surgery

For any indication for surgery, resection serves one purpose - to preserve as much as possible the healthy tissue of the organ in which the eggs are located.

The surgeon removes a benign tumor or ovarian cyst in such a way as to minimally affect the gland itself. He opens the lining of the organ and excises the required minimum of tissue to gain access to the tumor. Next, the tumor is isolated from the organ with a blunt instrument and excised. Sutures are not applied to the remaining defect in order to reduce the depth and size of the postoperative scar. Bleeding vessels in the wound are cauterized with a coagulator.

Video: "Technique for performing ovarian resection"

Resection of the ovary in polycystic disease is carried out to stimulate ovulation. To do this, the surgeon either removes part of the dense membrane of the organ, or makes 6-8 incisions on it in different places.

Sometimes a wedge-shaped resection of the ovary is performed - a triangular section of tissue is cut out of it, the base of which faces the organ capsule. In this way, it is possible to remove a significant area of ​​the membrane and preserve a large mass of ovarian tissue.

Surgery for ovarian trauma, rupture of a cyst with hemorrhage into the abdominal cavity (apoplexy) is carried out in order to remove the damaged part of the organ. Removal of the pathological focus is performed sparingly, that is, minimally involving healthy tissue. In some cases, only drain the wound and stop the bleeding with a coagulator.

Sometimes an ovarian biopsy is performed for diagnostic purposes. To do this, the surgeon cuts out a small section of the organ in the form of a wedge, which is then sent to the laboratory for examination. Sutures are not placed at the site of the defect; bleeding vessels are cauterized.

The gland is completely removed when:

  • large size benign tumor;
  • an abscess that developed after invasive intervention.

Recovery period and possible consequences of ovarian resection

With partial resection of the ovary, the postoperative period is 2 weeks, with complete removal of the ovary - 6-8 weeks.

Complications are the same as with any other operation:

  • bleeding;
  • perforation of abdominal organs;
  • side effects of anesthesia;
  • adhesive process;
  • postoperative hernia;
  • wound infection.

With any volume of surgical intervention, there is a decrease in the amount of tissue of the reproductive gland, which contains immature eggs. Their supply in the female body is limited and averages from 400 to 600 cells. Each ovulation, at least 3-4 of them are consumed, one matures into a full-fledged egg, and 2-3 help it grow. As a result of the operation, the period during which a woman is able to conceive is artificially reduced.

Immediately after surgery, the level of sex hormones decreases significantly, since the damaged organ is not able to produce the same amount. In response to this, the hypothalamic-pituitary system increases the release of follicle-stimulating and luteinizing hormones into the blood, under the influence of which the remaining gland tissue begins to more actively synthesize its own. Restoring the balance takes 2-3 months, and during this period the gynecologist prescribes a hormonal contraceptive drug to support the process from the outside.

Menstruation after ovarian resection often begins the next day after the operation, as the body’s reaction to it. After two weeks, ovulation occurs and the previous cycle is restored.

When to plan pregnancy?

Sexual activity after laparoscopic ovarian resection is possible from the seventh day of the postoperative period. Surgery and removal of part of the ovarian tissue do not disrupt the ovulation process, so the woman remains able to conceive a child. For nulliparous women or those who want to have more children, gynecologists recommend planning a pregnancy in the next year or two after surgery.

With polycystic disease, when surgery is performed to stimulate ovulation, the likelihood of conception is greatest in the first six months after surgery. Then the capsule of the gland thickens again and it will be much more difficult to get pregnant, since the egg cannot reach its surface.

If pregnancy does not occur within six months after resection of an ovarian cyst and there are other factors of infertility in one of the spouses, the couple is referred to a reproductive specialist to resolve the issue of IVF (in vitro fertilization). Hormonal stimulation with a limited egg reserve is most often carried out with high doses of drugs during one cycle (short protocol), which allows obtaining a sufficient number of mature follicles. Recently, androgen priming has been used - the introduction of a precisely selected dose of testosterone, which in the female body serves as a precursor to its own sex hormones. This technique allows you to achieve egg maturation in a more natural way.

Estimated cost

The cost of surgical treatment depends on the volume of the intervention, its technical complexity and the level of the clinic. On average, the price for removal of an ovarian cyst ranges from 30 to 70 thousand rubles, surgical treatment of polycystic disease from 25 thousand and above.

The development of modern surgery is aimed at making the intervention as gentle as possible on the organ, but at the same time effective. This approach is especially relevant when treating diseases of a woman’s reproductive system, because not only the ability to conceive and bear a child, but also her health in general depends on it.

If, as a result of hormonal disorders, a woman experiences fluid accumulation under the outer membranes of the ovary - a cyst develops, or malignant cells are found in it, the treating gynecologist will recommend removing the pathological area.

Surgical treatment can also be chosen for polycystic ovary syndrome if it is necessary to preserve the patient’s reproductive function. In all these cases, gynecologists say that resection of the ovarian tissue is necessary.

What is ovarian resection?

This is a surgical intervention in which only the damaged area is removed (excised) in one or both organs, while healthy tissue remains intact. This operation does not involve complete removal of these reproductive glands, so in most cases the woman’s ability to conceive is preserved. Moreover, sometimes ovarian resection is performed in order to increase the chances of pregnancy.

Intervention is performed only when strictly necessary and only after a comprehensive examination of the woman - in order to minimize the risk of postoperative complications. If you want to get pregnant after surgery, therapy may be prescribed to stimulate the female reproductive glands to increase the production of eggs.

Types of surgery and indications for it

There are three main types of surgical interventions on the ovaries:

  1. Partial resection.
  2. Wedge resection.
  3. Oophorectomy.

Partial resection of the ovary

This is the cutting off of part of an organ. It is used to treat diseases such as:

  • a single ovarian cyst, when it reaches a significant size and does not respond to conservative treatment methods;
  • hemorrhage into the ovarian tissue;
  • severe inflammation of the organ, especially when it has become saturated with pus;
  • a benign ovarian tumor confirmed by a preliminary biopsy (puncture and removal of part of unhealthy tissue), for example;
  • organ injury, including during a previous operation, for example, on the intestines or urinary tract;
  • rupture of an ovarian cyst with bleeding into the abdominal cavity;
  • torsion of the pedicle of the ovarian cyst, which is accompanied by severe pain;
  • ectopic ovarian pregnancy, when the embryo develops on top of the organ.

Wedge resection

They can proceed to oophorectomy with the initial planning of partial resection of ovarian tissue - if during the operation it turns out that it is not a glandular pseudomucinous cystoma. In the latter case, after 40 years of age, both reproductive glands are removed altogether in women to avoid their cancerous degeneration.

Resection of both ovaries will be carried out if cysts develop in both of them, especially with glandular pseudomucinous cystomas. If a papillary cystoma is discovered, which is dangerous due to its high risk of cancerous degeneration, both ovaries are removed in women of any age.

Methods for performing ovarian resection

Ovarian resection can be performed by two methods: laparotomy and laparoscopic.

Laparotomy excision of the organ is carried out through an incision at least 5 cm long, made with a scalpel. Resection is performed under direct visual control using conventional instruments: scalpel, clamp, tweezers.

Laparoscopic ovarian resection

Laparoscopic ovarian resection is performed as follows. 3-4 incisions no longer than 1.5 cm are made in the lower abdomen. Medical steel tubes - trocars - are inserted into them. Through one of them, a sterile gas (oxygen or carbon dioxide) is pumped into the abdomen, which will move the organs away from each other. The camera will be inserted through the second hole. It will transmit an image to the screen, and gynecological surgeons will be guided by it when performing an operation. Small instruments are inserted through other incisions and used to perform the necessary actions. After carrying out the necessary actions, carbon dioxide is removed and the incisions are sutured.

Preparing for the intervention

Before the operation, you need to be thoroughly examined: undergo general clinical and biochemical blood tests, determine the presence of antibodies to viruses that can reduce blood clotting (hepatitis B and C) or reduce immune defense (HIV). A cardiogram and fluorogram are also needed.

Both laparotomy and laparoscopic interventions are performed under general anesthesia, during which all muscles, including those located between the stomach and esophagus, are relaxed. As a result, stomach contents can be thrown into the esophagus, and from there into the respiratory tract, which can cause pneumonia. Therefore, before surgery, you need to stop eating, taking your last meal at 8 pm (no later), and liquids at 10 pm.

In addition, you will need to cleanse the intestines: after all, surgical intervention will temporarily slow down intestinal motility, so the feces formed in it will be absorbed into the blood, poisoning the body. To prevent this from happening, you need to perform cleansing enemas. They are done with cool water in the evening and in the morning the day before until the water is clear.

How is the operation performed?

The intervention is performed under general anesthesia, so after getting on the operating table and injecting drugs into a vein, the woman falls asleep and stops feeling anything.

Meanwhile, the operating gynecologist makes either one large (laparotomy) or several small (laparoscopic) incisions, and with the help of instruments the following is performed:

  1. Freeing the organ and its cyst (tumor) from adjacent organs and adhesions.
  2. Applying clamps to the suspensory ligament of the ovary.
  3. An incision is made into the ovarian tissue that extends slightly higher than the pathologically altered tissue.
  4. Cauterization or suturing of bleeding vessels.
  5. Suturing the remaining gland using absorbable thread.
  6. Examination of the second ovary and pelvic organs.
  7. Check for the presence of bleeding vessels, their final suturing.
  8. Installation of drainage(s) into the pelvic cavity.
  9. Stitching of cut tissues through which the instrument was inserted.

The patient is warned that even with a planned laparoscopic intervention, in the case of suspected cancer, or in case of extensive purulent inflammation or blood impregnation, gynecologists can proceed to a laparotomy approach. In this case, the life and health of the patient are given priority over the faster recovery of her ovary after resection, which is noted during laparoscopic surgery.

Consequences and postoperative period

Performed using minimally traumatic methods (laparoscopy), with the minimum possible amount of tissue removed, the operation usually goes smoothly. The consequences of ovarian resection can only be the onset of menopause soon after the operation - if a lot of tissue has been removed from both organs, or the acceleration of its onset - since the tissue from which new eggs could appear has disappeared.

The second common consequence is adhesions between the intestines and reproductive organs. This is the second reason why pregnancy may not occur after ovarian resection (the first is the removal of a large amount of ovarian tissue).

Complications may also develop. These are infections of the pelvic organs, hematomas, postoperative hernias, and internal bleeding.

Pain after ovarian resection begins within 5-6 hours, and therefore the woman in the hospital is given an anesthetic injection. Such injections are performed for another 3-5 days, after which the pain should decrease. If the pain syndrome persists for more than a week, you need to notify the doctor about this - this indicates the development of complications (most likely, adhesive disease).

The sutures are removed within 7-10 days. Complete recovery after surgery occurs in 4 weeks with laparoscopic surgery, and in 6-8 weeks with laparotomy.

After the operation, blood discharge from the vagina is observed, which resembles menstruation. The intensity of the discharge should decrease, and the duration of this reaction of the body should be about 3-5 days. Menstruation rarely comes on time after ovarian resection. Their delay of 2-21 days is considered normal. A longer absence of menstruation requires consultation with a doctor.

Ovulation after ovarian resection is usually observed after 2 weeks. This can be found out by measuring basal temperature or by (ultrasound) data. If the doctor prescribed you to take hormonal medications after surgery, then you may not have it at all that month, but you need to ask your treating gynecologist about this.

Is it possible to get pregnant after ovarian resection?

If a large amount of ovarian tissue has not been removed, then it is possible. Even with polycystic disease, this is possible, and even necessary, otherwise after 6-12 months the chance of getting pregnant will decrease, and after 5 years a relapse of the disease is possible.

Only in the first 4 weeks after surgery, sexual intercourse will need to be excluded for normal healing of the operated tissue, and then, perhaps, hormonal contraceptives will need to be taken for another 1-2 months. During the same period, you need to pay active attention to the prevention of adhesive disease: active motor regimen, physical therapy, and a diet rich in fiber.

If pregnancy does not occur after 6-12 months, you need to consult a doctor and exclude the possibility of tubal infertility.

Are there problems with pregnancy after ovarian resection?

Ovarian resection is an operation to remove a damaged area of ​​an organ.

The indications for this most often are various cysts and cystomas.

The first include:

  • follicular cysts;
  • Corpus luteum cysts.

To the second:

  • endometrioid cysts;
  • dermoid tumors;
  • various types of cystadenomas.

Polycystic ovary syndrome - even in our time it is not always possible to cure it conservatively. In such cases, it is automatically transferred to another indication for surgical intervention for the purpose of ovarian resection.

Well, don’t forget about such an emergency condition as ovarian apoplexy - that is, its rupture due to some, often advanced, disease.

Is pregnancy possible?

Ovarian resection is one of the most common gynecological operations performed on women of reproductive age. Most of them subsequently ask the question: “Is pregnancy possible after ovarian resection?” It would seem, why not? Let's look at this question in more detail.

All women are born with a certain non-replenishable supply of follicles (the so-called ovarian reserve), distributed throughout the entire thickness of the ovary. With the onset of puberty, their number begins to gradually decrease. The reason for this is the ovarian-menstrual cycle: the follicle goes through all stages of development and leaves the ovary in the form of an egg, ready for fertilization.

Based on this, we understand that after resection of the ovary, a woman loses some of the follicles and if there were few of them at the time of the operation, she has a chance to remain infertile. However, in most cases such surgery is performed at a young age, when low ovarian reserve is extremely rare. In this case, there is no need to worry.

Unfortunately, this is not the only pitfall of the consequences of the operation. The 21st century is the time of minimally invasive operations. These are laparoscopic operations that were supposed to save us from the adhesive process - one of the most terrible consequences of surgical interventions on the abdominal and pelvic cavity. Thanks to this, the adhesive process develops in a minimal amount and in miniature sizes. Unfortunately, these sizes are enough to close the entrance to the fallopian tube and then the egg will have nowhere to go. There is a way out - to perform a repeat operation to remove adhesions. Sometimes this has to be done over and over again.

To summarize, achieving pregnancy after resection of the ovary is much easier than, for example, curing amphetamine addiction. At a minimum, there is a second ovary, which without difficulty and in any outcome will take over the function of both. And the resected ovary will work no worse than before, turning on the compensatory mode, if, of course, the fallopian tube is clean. There is always a risk, so doctors recommend planning a pregnancy by waiting 2-3 months after ovarian resection. If, after six months of regular non-contraceptive attempts at pregnancy, pregnancy has not occurred, you should contact a fertility specialist with a view to possible in vitro fertilization, or to look for other methods of solving the problem.

Uterine fibroids are often diagnosed in women of childbearing age. At the initial stages, doctors try to cure the tumor using conservative, mainly hormonal therapy. But in cases where a benign tumor grows rapidly and poses a threat to the patient’s health, the only treatment method is surgical removal of the fibroid. It is at this moment that women who want to have children ask the question: “Is pregnancy possible after removal of uterine fibroids?”

The tumor is mainly localized in the smooth muscle layer of the reproductive organ; in rare cases, the pathological focus can be located in the cervix. According to medical statistics, more than half of women diagnosed with uterine fibroids have a high chance of becoming pregnant and going through the entire period of pregnancy and childbirth without complications.

The success of conception depends on the location and size of the tumor. There are cases when the tumor blocks the lumen of the fallopian tubes and makes it impossible for the fertilized egg to attach to the uterine cavity. But even if a woman manages to become pregnant, there remains a high probability of spontaneous abortion in the very early stages. We should not forget that during pregnancy, serious hormonal changes occur in the female body, so it is almost impossible to predict in advance how fibroids will behave.

The development of the disease during pregnancy is very unpredictable and dual in nature:

  • In some cases, myomatous nodes, under the influence of a woman’s changed hormonal levels, not only decrease in size, but can also completely resolve without any medical intervention;
  • The other side of the coin is the intense uncontrolled growth of a benign tumor under the influence of increased hormone production, which in the future can cause spontaneous abortion.

Therefore, doctors are faced with a very difficult dilemma: to allow the patient to become pregnant with fibroids, or to first remove the tumor and then plan conception. If specialists are inclined towards preliminary surgical intervention, then after a full examination, the doctor must select the optimal method for removing fibroids in each specific case. Whether it is possible to get pregnant after removal of fibroids depends on many factors, so no doctor will give a 100% guarantee.

Methods for removing fibroids

Today, there are various techniques for performing myomectomy. When choosing the method by which surgical intervention will be performed, the doctor takes into account the growth rate and size of the node, its location and other clinically important parameters. The most popular methods of myomectomy are:

  • Hysteroscopic removal– used in women with a submucosal location of the myomatous node. The operation is performed using a hysteroscope through the cervix. This method of removal has clear advantages for those patients who wish to become pregnant in the near future. The surgery is performed under general anesthesia; the duration of an uncomplicated operation rarely exceeds 15 minutes. The tumor can be removed mechanically, laser, or electrosurgically. The advantages of hysteroscopy are minimal trauma, painlessness, and quick rehabilitation.
  • Laparoscopic removal– used when a sufficiently large volume of surgical treatment is necessary and in cases where there is a question of complete removal of the reproductive organ with or without appendages. After laparoscopic removal of myomatous nodes, pregnancy occurs more often than with laparotomy (the open method of removal is more aggressive and traumatic). Among the advantages of this method, one can note the easy and rapid course of the postoperative period.

  • Arterial embolization method– is based on blocking the lumens of the vessels that feed the fibroids by introducing a special sclerosing substance into them. Due to the blocking of the lumen of the vascular network, the blood supply to the pathological area is disrupted and subsequent necrotization (tumor death) is observed. This technique is innovative, so it is too early to judge the consequences and complications. But experts consider the UAE technique to be one of the safest for those who want to get pregnant. Feedback from patients is mostly positive, therefore, despite the high cost of this procedure, many women choose this method of removing fibroids.

Complications affecting pregnancy

Despite the fact that most gynecologists stubbornly insist on removing fibroids, even in nulliparous patients, it is still worth carefully weighing all the risks. Of course, widely used hystero- and laparoscopic operations are low-traumatic and do not pose a threat to life, but at the same time they do not provide a complete guarantee that a woman will be able to have children in the future.

Any surgical intervention can negatively affect future pregnancies.

Therefore, when it will be possible to plan conception is determined only by the attending physician.

Possible complications:

  • ectopic pregnancy;
  • spontaneous abortions at different stages of pregnancy;
  • formation of adhesions;
  • relapses of the disease;


  • massive uterine bleeding during childbirth;
  • damage to the uterus during childbirth in the area of ​​the postoperative scar (up to organ rupture);
  • abnormalities of fetal development associated with disruption of uterine trophism due to nodular formations.

Rehabilitation period

In order to increase the chance of becoming pregnant and giving birth to a healthy baby after conservative myomectomy, a woman must responsibly follow the rules of rehabilitation.

  1. In the first days it is necessary to follow a therapeutic diet. Eating foods rich in fiber is the first way to prevent constipation;
  2. Completely eliminate physical activity that puts stress on the pelvic and abdominal organs;
  3. Be sure to wear a specialized bandage that is correctly sized for at least a month;
  4. It is advisable to engage in exercise therapy groups.

It is important to regularly visit a gynecologist who will monitor the condition of the pelvic and abdominal organs and help plan a pregnancy after treatment for uterine fibroids.

Chances of conceiving after fibroid removal

The ability to become pregnant after removal of fibroids directly depends on the volume of surgical treatment performed. Also important is the state of the woman’s reproductive system and hormonal levels, both in the early and late postoperative periods. Strict adherence to the instructions and recommendations of the attending physician will help you properly plan your pregnancy after myomectomy and give birth to a healthy baby.


After successful surgical treatment of fibroids, the chances of getting pregnant are quite high. But it is important not only to conceive, but also to bear a child. To ensure pregnancy and childbirth without complications, doctors recommend planning conception no earlier than a year after surgical removal of fibroids, and after complex strip surgery can you get pregnant only after 2 years. Motherhood after removal of fibroids is quite possible; more than 50% of treated women successfully give birth to healthy children.