A woman became pregnant and gave birth four years after having her fallopian tubes removed. Here's how that's possible.

  • Elizabeth Kough had her fallopian tubes removed in 2015 to prevent future pregnancies, so she was surprised to learn she was pregnant again in 2018, People magazine reported.
  • In March 2019, Kough gave birth to a healthy baby, Benjamin.
  • Although situations like Kough’s are extremely rare, they are possible, according to Dr. Brooke Hodes-Wertz, assistant professor in the Department of Obstetrics and Gynecology at the NYU Langone Fertility Center.
  • Most women without fallopian tubes who have successful pregnancies become pregnant through in vitro fertilization. Otherwise, the pregnancy is likely to be an ectopic pregnancy that has to be terminated.
  • Visit INSIDER’s homepage for more.

In 2015, Elizabeth Kough, a mother of three, had her fallopian tubes removed in order to prevent future pregnancies. Since sperm typically fertilize an egg in the fallopian tubes, removing them via a medical procedure prevents that from happening.

So when Kough learned in 2018 that she was pregnant with her fourth child, she was shocked, People reported.

“Once I found out that I was pregnant I was very concerned that the baby was going to be in my abdominal cavity, but we were floored and excited that he was actually in my uterus where he was supposed to be,” she told People.

In March, Kough gave birth to the baby, named Benjamin. She told People that her doctors tried to figure out how she was able to get pregnant without fallopian tubes and they guessed it was because her surgery had been botched.

But after looking at her medical records and examining her organs during the C-section she needed to give birth to Benjamin, they confirmed that Kough’s fallopian tube removal procedure had indeed been successful.

“There were no tubes, and Benjamin is a very rare baby. It’s very rare that this occurred and we are very blessed to have him here,” Kough said.

Usually, getting pregnant without fallopian tubes requires a medical procedure

When a woman with all of her reproductive organs gets pregnant, it’s because an egg drops from her ovaries and is “sucked up,” by the fallopian tubes, Dr. Brooke Hodes-Wertz, assistant professor in the Department of Obstetrics and Gynecology at the NYU Langone Fertility Center, told INSIDER. Once inside, sperm meet the egg in the tubes and fertilize it into a zygote. From there, the zygote enters the uterus through the tubes and grows into an embryo.

Female reproductive system anatomyShutterstockThe anatomy of the female reproductive system.

If a woman doesn’t have fallopian tubes – which usually happens because she had a complication that required the tubes be removed – she typically needs in vitro fertilization (IVF) to become pregnant, since the process can avoid the tubes altogether, according to Dr. Hodes-Wertz.

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Kough’s situation is extremely rare and usually leads to complications, but it’s possible

Kough’s natural pregnancy without fallopian tubes, then, is puzzling to medical professionals. “It’s very unusual and only a few case reports exist of this happening in the past,” Dr. Hodes-Wertz said.

The only way it can happen is if there’s a small opening in the tissue where the fallopian tubes had connected with the uterus. “You hope [that tissue] is closed [during surgery], but that’s not always the case,” Dr. Hodes-Wertz said.

That opening, then, allows for a sperm and egg to meet somewhere in the woman’s abdominal cavity, though it’s unclear exactly where the egg and sperm develop into an embryo, according to Dr. Hodes-Wertz. If it’s outside of the uterus, it then still has to find its way to the uterus in order to grow safely throughout the pregnancy. If it doesn’t, it would become an ectopic pregnancy, or a pregnancy that grows outside of the uterus and must be terminated through a surgical procedure or medication, according to American Pregnancy Association.

“The majority of pregnancies that occur after fallopian tube removal are going to be ectopic because [the embryos] don’t have ability to make it back to the uterus,” Dr. Hodes-Wertz said. “It’s very miraculous the sperm would find the egg and then make it’s way into the uterus.”

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