Medical Oncologist
CION Cancer Clinics
Fertility after ovary removal: what changes with one ovary, and with none | CION Cancer Clinics
If one ovary is removed and the other is healthy, you can usually still get pregnant naturally. The remaining ovary releases an egg most months and periods carry on. If both ovaries are removed, natural pregnancy is no longer possible, so anything you want to preserve has to be arranged before the operation. This page explains what decides your chances, and what to ask for. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Can you still get pregnant with one ovary?
- One ovary removed and both removed, compared
- What decides your chances with one ovary
- What to do if children matter to you
- Four things families say, and what is actually true
- When to try, and when to ask for help
- Common questions about fertility after ovary removal
The short answer
Can you still get pregnant with one ovary?
Yes, usually. If one ovary and its tube are removed and the other side is healthy, the remaining ovary carries on releasing an egg most months and natural pregnancy stays possible. If both ovaries are removed, natural pregnancy is no longer possible, whatever your age.
Why one ovary is usually enough
Each ovary holds far more eggs than a woman will ever release. When one is removed, the other does not have to work twice as hard. It simply keeps doing what it did, and the womb receives its egg from that side each month instead of alternating. Periods normally continue as before, and hormone levels stay in the normal range.
Where it is less simple
Fertility with one ovary is not identical to fertility with two. The total egg store is smaller, so the natural menopause may arrive somewhat earlier than it otherwise would have. If the remaining ovary has been damaged by cysts, endometriosis, earlier surgery or chemotherapy, the picture changes again. And if the tube on the remaining side is blocked, the egg cannot reach the womb even though the ovary is working.
This page cannot tell you your own chances. Those come from your age, the ovary that is left, its tube and your partner's fertility, and a specialist can measure most of them.Side by side
One ovary removed and both removed, compared
One ovary removed
Both ovaries removed
Periods usually continue as before
Periods stop at once
Natural pregnancy remains possible
Natural pregnancy is no longer possible
Hormone levels stay in the normal range
Menopause begins, unless past it already
Menopause may come a little earlier than it would have
Menopause is immediate and hormone replacement is discussed
Egg freezing is rarely needed but can be discussed
Egg or embryo freezing must happen before the operation
Not sure whether this applies to you?
Ask an oncologistWhat matters most
What decides your chances with one ovary
The operation itself is only one part of the answer. These four things usually count for more.
Your age
Egg number and quality fall with age whether you have one ovary or two. A woman in her twenties with one ovary generally has higher chances than a woman in her late thirties with both. Age is the biggest factor of all.
The ovary that is left
A healthy ovary with a good egg store behaves normally. One that has had cysts removed, or has endometriosis, or has been through chemotherapy, may hold fewer eggs. A blood test and a scan can estimate this before you start trying.
The tube on that side
The egg has to travel down the fallopian tube to meet the sperm. If the remaining tube is blocked or scarred, the ovary may be working while pregnancy still does not happen. A dye test or scan can check this, and IVF can bypass a blocked tube.
What the surgery was for
If the ovary was removed for a benign cyst or a twist, fertility is usually little changed. If it was removed for cancer, any chemotherapy that follows can affect the other ovary, and some treatments mean pregnancy must wait. Ask your oncologist how long.
Before the operation
What to do if children matter to you
Say so at the first appointment
Tell the surgeon plainly that you want children, or might. It changes which operation is planned, whether the second ovary can be kept, and whether a fertility referral is made before the date is set.
Ask whether one ovary can stay
For many benign conditions and some early cancers confined to one side, the other ovary is left. Where the reason is an inherited gene fault, both usually have to go, and the conversation moves to freezing eggs or embryos first.
See a fertility specialist before the date
A blood test and a scan of the ovaries show your egg store. If both ovaries are coming out, this visit is where egg or embryo freezing is arranged. It needs a short delay, and your surgeon will say whether that delay is safe.
Ask about treatment after surgery
Chemotherapy or radiotherapy to the pelvis can damage the ovary that is left. If either is likely, ask whether it can be protected, and how long after treatment you should wait before trying for a pregnancy.
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Commonly believed
Four things families say, and what is actually true
"With one ovary she will only be able to conceive
every other month."
The remaining ovary usually releases an egg every month, not every second month. The two ovaries do not take strict turns even when both are present, and one on its own picks up the cycle.
"Removing an ovary for cancer means she can never
have children."
If one ovary and the womb are kept, pregnancy is often still possible after treatment ends. Where both ovaries must go, eggs or embryos frozen before surgery can still be used later if the womb remains.
"She should get pregnant as soon as possible after
surgery, before the other ovary fails."
The remaining ovary does not fail because its partner is gone. Pregnancy should wait until you have recovered and until any cancer treatment is finished. Your oncologist will tell you when it is safe to try.
"IVF will not work with only one ovary."
IVF works with one ovary. Fewer eggs may be collected in each cycle, and the specialist will plan for that. A blocked tube on the remaining side is a reason for IVF, not a reason against it.
The question I most want asked before the operation, and least often hear, is "do I want children one day". Once the ovary is out, the answer changes what we can offer.Dr. Muralidhar Muddusetty, Consultant Surgical Oncologist, CION Cancer Clinics
Being straight with you
When to try, and when to ask for help
Once you have healed and any cancer treatment is finished, most couples are told they can try naturally. There is no special waiting rule because you have one ovary. The waiting, if any, is set by the treatment you had, not by the operation.
When to see a fertility specialist
If you are under thirty-five and have been trying for a year, or over thirty-five and have been trying for six months, ask for a referral. Because your egg store is smaller than it was, it is reasonable to ask sooner rather than later, especially if your periods have become irregular or lighter since the operation.
Signs the remaining ovary is struggling
Periods that stop or become very irregular, hot flushes, night sweats or vaginal dryness in a woman under forty are worth a blood test. They can mean the ovary is running low earlier than expected. This is not an emergency, but it is a reason to be seen, because options narrow as time passes.
Who this page does not cover
If your womb was removed along with the ovary, natural pregnancy is not possible even with a working ovary. If both ovaries were removed, the page on egg freezing before surgery is the one for you.
Bring your operation note and pathology report to the fertility appointment. They tell the specialist exactly what was removed and what was left.Questions we are asked
Common questions about fertility after ovary removal
Will my periods change after one ovary is removed?
Usually not. The remaining ovary keeps making the same hormones, so periods carry on much as before. A few women notice some irregularity in the first cycles while the body settles after surgery. If periods stop or become very irregular for several months, ask for a blood test.
Does the other ovary take over and release an egg every month?
Yes. Ovulation does not strictly alternate between sides even in women with two ovaries. With one ovary, that side releases an egg most months on its own. Your chance of conceiving in any given month is close to what it was, with age being the bigger influence.
Will I reach the menopause earlier?
Possibly a little earlier, because the total egg store is smaller. For most women the difference is modest, and many reach the menopause at the usual age. If you are planning children in your late thirties, this is a reason to have your egg store checked rather than assume there is time.
Can I have IVF with one ovary?
Yes. IVF stimulates whichever ovary is present and collects the eggs directly from it, so the tube on that side does not even need to be open. Fewer eggs may be collected per cycle than with two ovaries. The specialist will adjust the plan for that.
Both my ovaries are coming out. Is there anything I can do?
Yes, but it must happen before the operation. Eggs or embryos can be collected and frozen over a short cycle of injections, then used later if your womb is kept. Ask your surgeon whether the operation can safely wait for that, and ask for the fertility referral the same day.
How soon after surgery can we start trying?
Once the wound has healed and your surgeon is happy, usually after the first follow-up. If you are having chemotherapy or other treatment afterwards, wait until your oncologist says it is safe; some treatments need a gap before pregnancy. Ask for that timing in writing.
Will pregnancy be riskier with one ovary?
The pregnancy itself is not affected by having one ovary. Once an egg is fertilised and the womb is healthy, the ovaries play only a small part. Your obstetrician should know your surgical history, but you would not normally need extra monitoring for this reason alone.
Is fertility treatment covered by insurance or Aarogyasri?
Fertility treatment is usually not covered by Aarogyasri, CGHS, ECHS or EHS, and most cashless insurers exclude it too, even when the cause is a cancer operation. Ask the fertility centre for a written estimate before you begin, and ask whether any part of the testing is covered under your surgical admission.
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Dr. C. Raghavendra Reddy
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
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Radiation Oncologist
Radiation Oncologist
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NHS — Infertility
- Cancer Research UK — Surgery for ovarian cancer
- National Cancer Institute — Fertility Issues in Girls and Women with Cancer
- NHS — IVF
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Egg Freezing Before Ovary RemovalWhat has to happen before both ovaries are removedOne Ovary or Both: What DecidesWhen the second ovary can be keptOophorectomy in Young Women: What to WeighBones, heart, mood and fertility after early removalOvarian Cyst Removal vs Ovary RemovalWhen the ovary can be saved altogetherRecovery, Eating and Getting Back to LifeHealing before you start trying
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Worried about fertility before ovary surgery?
Send us your report or call the helpline. A surgical oncologist will explain what can be kept, what can be preserved, and who to see first. One helpline serves every CION centre.