A bilateral oophorectomy, the surgical removal of both ovaries, fundamentally alters a person’s reproductive capacity. Pregnancy cannot be achieved naturally after this procedure. The ovaries are the sole source of female reproductive cells (eggs) and the hormones required to regulate the menstrual cycle and sustain a pregnancy. Without them, the body enters surgical menopause, making conception through traditional means biologically impossible. Advanced medical technology is necessary to pursue parenthood.
The Physiological Role of Ovaries in Natural Conception
The ovaries fulfill a dual function foundational to natural conception. They produce gametes (oocytes or eggs) that must be fertilized by sperm to create an embryo. Additionally, the ovaries are endocrine glands that secrete the steroid hormones estrogen and progesterone, which orchestrate the entire reproductive cycle.
Estrogen dominates the first phase of the cycle, prompting the growth and thickening of the uterine lining (endometrium). After ovulation, the remaining ovarian structure transforms into the corpus luteum, which secretes progesterone. Progesterone prepares the endometrium to become receptive for the implantation of a fertilized egg, supporting early pregnancy. The loss of both ovaries eliminates the egg and the hormonal signals required to regulate this complex monthly process.
Maintaining the Uterus for Potential Gestation
It is important to distinguish between a bilateral oophorectomy and a hysterectomy (removal of the uterus). While the ovaries are removed in an oophorectomy, the uterus may remain intact, preserving the potential to carry a pregnancy. If the uterus is present, the focus shifts to providing an environment for gestation. This capacity is entirely dependent on external support, as the body no longer produces the necessary hormones internally.
To prepare the uterine lining for a potential embryo, a specific Hormone Replacement Therapy (HRT) protocol must be initiated. This treatment involves administering a sequential regimen of estrogen and progesterone to artificially mimic a natural hormonal cycle. Estrogen is given first to thicken the endometrium, followed by progesterone to make the lining receptive to an embryo transfer. Maintaining the uterus allows the person who has undergone an oophorectomy to still serve as the gestational parent.
Achieving Pregnancy Through Assisted Reproductive Technology
Since the body can no longer supply the necessary egg, achieving pregnancy requires Assisted Reproductive Technology (ART), specifically In Vitro Fertilization (IVF) with donor eggs. This medical pathway bypasses ovarian function entirely by sourcing eggs from a healthy, screened donor. The process begins with selecting a suitable egg donor, often a younger woman with good reproductive health. The donor undergoes hormone injections to stimulate multiple egg production, which are then retrieved through a minor outpatient procedure.
The retrieved donor eggs are fertilized in a laboratory using sperm from the intended father or a sperm donor. The resulting embryos are monitored for several days before a select number are chosen for transfer. Simultaneously, the recipient’s uterus is prepared with the customized HRT regimen of estrogen and progesterone to ensure optimal lining thickness and receptivity. After the embryo transfer, the patient continues hormonal support for several weeks to maximize the chances of successful implantation and ongoing pregnancy.
Success rates for IVF using donor eggs are generally high because the gamete quality is often better than those from an older recipient. Data suggests the live birth rate per transfer with donor eggs is often 50% or higher, though individual results vary. This option allows the recipient to experience pregnancy and childbirth, even without ovarian function. The resulting child shares the genetic material of the egg donor and the sperm source, which introduces complex legal and emotional considerations for intended parents.
Gestational Carriers and Surrogacy
In some situations, a person may be unable to carry a pregnancy even if donor eggs are available. This occurs if the person previously underwent a hysterectomy (uterus removal) or if a medical condition prevents the uterus from safely sustaining a full-term pregnancy. When this is the case, the final option for achieving parenthood is through a gestational carrier, commonly referred to as a surrogate.
A gestational carrier is a woman who agrees to carry a pregnancy for the intended parents, using an embryo created via IVF outside her body. The embryo is typically created using a donor egg and the intended father’s sperm, or both donor egg and donor sperm. The carrier receives hormone medication to prepare her uterine lining for the embryo transfer. The carrier provides the host environment but shares no genetic material with the child, ensuring the intended parents can still welcome a child into their family.