Lena Dunham has become a mum after undergoing a hysterectomy at 31, with the Girls creator and her husband, Luis Felber, welcoming their first child via surrogate.

Dunham had the surgery after years of severe endometriosis-related pain. She later had an ovary removed after it became severely affected by scar tissue and fibrosis, according to reports.

Her story may leave some wondering: what exactly is removed during a hysterectomy, and how can someone become a parent after the procedure?

What Is Removed During a Hysterectomy?

A hysterectomy is an operation to remove the womb, also known as the uterus. The womb is the organ where a pregnancy develops, meaning someone can no longer become pregnant or carry a pregnancy after having the procedure.

However, the word 'hysterectomy' does not automatically mean that every reproductive organ is removed.

With a total hysterectomy, the womb and cervix are removed. A subtotal hysterectomy removes the main body of the womb while leaving the cervix in place.

In some cases, surgeons may also remove the fallopian tubes and ovaries. This is known as a total hysterectomy with bilateral salpingo-oophorectomy. The NHS notes that ovary removal is not automatically required and is generally considered based on a person's medical circumstances and risk of future problems.

Does a Hysterectomy Remove The Ovaries?

Not necessarily. The ovaries produce eggs and hormones, including oestrogen. If they are left in place, they can continue functioning after a hysterectomy, even though the person no longer has a womb in which a pregnancy can develop.

If both ovaries are removed, however, this causes an immediate surgical menopause in someone who has not already gone through menopause.

Can You Have Biological Children After a Hysterectomy?

A person who has had their womb removed cannot carry a pregnancy themselves. However, a hysterectomy does not necessarily mean that all eggs have been removed.

If functioning ovaries remain, eggs may potentially be retrieved and used in assisted reproduction, depending on the individual's circumstances. An embryo can then be transferred to a gestational surrogate, who carries the pregnancy.

That is broadly how someone who cannot carry a pregnancy can still potentially have a genetically related child.

In Dunham's case, she and Felber welcomed their daughter via surrogate. Dunham described the experience in a Vogue essay, including the emotional process of meeting and getting to know their surrogate before the embryo transfer.

Why Is a Hysterectomy Performed?

Hysterectomies can be recommended for several conditions, including heavy periods, long-term pelvic pain, fibroids and certain reproductive cancers. The NHS describes it as a major operation that is generally considered after less invasive treatments have been tried.

Endometriosis, which Dunham has spoken extensively about, can cause chronic pelvic pain and other symptoms when tissue similar to the womb lining grows elsewhere in the body.

Hysterectomy is not a universal treatment for endometriosis, and treatment decisions depend on the individual's symptoms, reproductive plans and medical circumstances.

The procedure remains relatively common in England. NHS figures show that 44,348 hysterectomy procedures were carried out in 2024/25 across English NHS hospitals and NHS-commissioned activity in the independent sector.

Dunham's experience therefore highlights an important distinction: having a hysterectomy means losing the ability to carry a pregnancy, but it does not necessarily mean losing the ovaries or the possibility of having a biological child through assisted reproduction.

Frequently Asked Questions

  • What is a hysterectomy?
    A hysterectomy is a surgical procedure to remove the womb, preventing the ability to carry a pregnancy.
  • Can you have biological children after a hysterectomy?
    Yes, if the ovaries are intact, eggs can be retrieved and used in assisted reproduction with a surrogate.
  • Does a hysterectomy remove the ovaries?
    Not necessarily. The removal of ovaries depends on individual medical circumstances.
  • Why is a hysterectomy performed?
    It is performed for conditions like heavy periods, pelvic pain, fibroids, and certain reproductive cancers.
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