What are the health effects of only having one ovary?

Dear Alice,

I'm a 19-year-old female. I had my right ovary removed (oophorectomy) three years ago due to a very large ovarian cyst. I was assured by my gynecologist that I'm still capable of bearing children but wasn't informed thoroughly of all of the pros and cons in regards to this type of operation (e.g., can the estrogen loss have any negative physical affects?). If you could shed some light on this matter, it would be greatly appreciated. Thanks.

— Desperate

Dear Desperate, 

Fertility is an individual journey and is experienced differently by everyone. Often fertility can be influenced by factors including age, weight, ovulation cycle, lifestyle, and sperm count of partner, among others. Because of this, it may be tricky to provide a concrete answer on your concern regarding bearing children following this procedure. However, the following information will hopefully shed light on the subject and provide some clarity. 

An oophorectomy, like the one you had, is a procedure that removes one or both ovaries. Oophorectomies are performed for a number of reasons, including the presence of ovarian cysts, benign tumors, ectopic pregnancies, endometriosis, ovarian cancer, and pelvic inflammatory disease (PID). While this procedure is generally safe and should alleviate symptoms caused by these conditions, there are risks and potential complications. Some of the risks associated with this procedure include the following: 

  • Fertility issues: If only one ovary is removed, there may be a lower chance of fertility, however, it’s still possible to get pregnant. If both ovaries are removed, and donor eggs are used, people may consider treatments like in vitro fertilization (IVF), which is a procedure that fertilizes the egg with sperm outside of the body. However, some studies suggest that IVF is less likely to be successful post-oophorectomy. 
  • Hormonal changes: Some studies have shown that having a bilateral oophorectomy, or the removal of both ovaries, may reduce the production of estrogen and progesterone. This may cause a person to experience early menopause. Symptoms may include hot flashes, mood swings, decreased sex drive, increased risk of osteoporosis, and vaginal dryness. Hormone replacement therapy may be offered to increase hormone levels. 
  • Cardiovascular disease: Those who have their ovaries removed before the age of 45 may be more prone to cardiovascular disease due to hormonal changes. 

As with any surgery, it can be important to remember that complications are possible. Potential complications include infections that can occur up to several weeks after surgery. These can lead to additional complications like sepsis. During surgery, nearby organs such as the bladder and bowels could also be damaged. 

Despite the risks and complications associated with oophorectomy, a healthy pregnancy is still possible if you are ovulating. Ovulation is a phase in the menstrual cycle when a mature egg is released from the ovary—typically once per month—and travels to the fallopian tube in preparation for fertilization. If one ovary is removed, the other ovary takes over the entire fertility function to produce eggs and hormones. Since pregnancy chances are higher during ovulation, understanding your cycle and any changes you may have experienced since the oophorectomy may help increase your chances of becoming pregnant. If you do choose to plan for pregnancy, you may consider speaking with a health care provider or fertility specialist. They may be able to perform tests—like an ultrasound—to ensure that your remaining ovary is functioning properly and assess if there are any further risk factors. They may also be able to provide more insight into where you are in your menstrual cycle so you can more accurately predict when you will be ovulating. 

If you choose to make an appointment with a health care provider, consider preparing a list of questions or concerns you have. Would you like to learn more about the oophorectomy procedure, itself? Would you like to know more about what health risks you should look out for in the future or what you can do to monitor these changes? Maybe you’d like to know what resources or treatments are available for you to manage any symptoms you may experience? Having an idea of what you would like out of this meeting can ensure that you’re able to address all of your concerns and questions. 

Hope this information was helpful in shedding some light on the matter! 

Last updated Sep 01, 2023
Originally published Jan 30, 2004

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