Michelle Le, who married a stranger on camera for the twentieth season of Married at First Sight, said in an interview released ahead of the season reunion that she had a hysterectomy in May after years of severe uterine fibroids. She can no longer carry a pregnancy. She and her husband Cameron Mitchell say they plan to look into surrogacy this fall.
Le, a 34-year-old program manager from Seattle, froze her eggs at 26 because of fibroids. She told TODAY that she spent roughly eight years trying to preserve her fertility before the surgery, describing her case as bad enough that the decision was effectively made for her.
That arc is more common than most people realize, and it is the part worth reading beyond the reality-television framing. Uterine fibroids affect a majority of women by age 50, and they are the leading reason for hysterectomy in the United States.
Common Growths with Uncommonly Wide Effects
Fibroids are benign tumors of the smooth muscle of the uterus. They affect up to 80 percent of Black women and 70 percent of white women by age 50, according to a physician briefing published by the University of Maryland Medical Center.
About one in three women with fibroids has symptoms that affect daily life. When they do, the burden is real: heavy menstrual bleeding, anemia, pelvic pain and pressure, recurrent pregnancy loss, urinary and bowel symptoms, and back pain. The rest often never know they have them.
The effect on fertility depends on location more than on size. Fibroids that press into or distort the uterine cavity can prevent an embryo from implanting or block the fallopian tubes. Those growing on the outer wall often have little effect on fertility.
Recurrence is the factor that shapes long-term decisions. One study cited in the same briefing found that 53 percent of fibroids recurred within five years and 84 percent within eight years, with reoperation rates of 7 and 16 percent, respectively. For a woman treated in her twenties who wants children later, the question is rarely settled in one go.
The Options Between Watching and Removing the Uterus
Hysterectomy is definitive. It is also the only option that ends the possibility of carrying a pregnancy, and it is generally reserved for women whose childbearing is complete. About 70 percent of women with symptomatic fibroids undergo one, and 38 percent of those are not presented with any other option to consider.
Myomectomy removes the fibroids and leaves the uterus, and it remains the standard approach for patients who want to keep the option of pregnancy. It can be done through a large incision, laparoscopically or robotically, or through the cervix when the fibroids sit inside the cavity. It does not prevent regrowth and is performed in only about 1 in 8 cases.
Uterine artery embolization shrinks fibroids by cutting off their blood supply and avoids surgery, though reproductive data are mixed and reintervention is not unusual. Radiofrequency ablation is newer and less invasive, with reintervention rates of roughly 4 to 12 percent through three years, but the Maryland briefing states plainly that it should not be offered to patients who want to become pregnant. MRI-guided focused ultrasound carries similar uncertainty. Medication options, including hormonal treatments, mainly control bleeding rather than eliminating fibroids.
Le's route through this reflects one of several paths. Freezing eggs in her twenties preserved genetic material that a hysterectomy could not touch, which is what makes surrogacy a realistic next step rather than a theoretical one.
Family Building After the Uterus Is Gone
A hysterectomy ends the ability to carry a pregnancy. It does not by itself end the possibility of a genetically related child, provided the ovaries were left in place or eggs or embryos were stored beforehand.
Gestational surrogacy uses the intended mother's eggs or previously frozen embryos, carried by another person. It is expensive, commonly running well into six figures in the United States once agency fees, legal costs, IVF and surrogate compensation are counted, and insurance rarely covers it. Legal treatment varies sharply by state, a point MedicalDaily has covered in reporting on a contested Texas surrogacy case now before the courts. Anyone considering it should retain a reproductive attorney licensed in the relevant state before signing anything.
Adoption and donor egg arrangements are separate paths with their own timelines and costs. Fertility medication pricing has also been in flux, as MedicalDaily reported in tracking a federal drug pricing deal whose promised coverage expansion has not arrived.
One detail is easy to miss in coverage of cases like this. Whether the ovaries were removed alongside the uterus changes everything downstream. When they are left in place, hormone production continues, and a woman does not enter surgical menopause, and her own eggs remain available for retrieval. When they are removed, menopause begins immediately regardless of age, and hormone therapy becomes a separate conversation. That question is worth asking before surgery, not after.
The practical takeaway for anyone with fibroids and future plans is about sequencing. Ask a gynecologist how the fibroids are positioned relative to the uterine cavity, since that drives the fertility question more than the count or the diameter. Ask whether a uterus-sparing option is realistic for this specific anatomy. Ask about fertility preservation before any procedure rather than after. A referral to a reproductive endocrinologist is reasonable at the point fibroids and family planning intersect, not years later.
Symptoms that warrant an appointment include periods heavy enough to soak through protection hourly, bleeding between periods, pelvic pressure or a feeling of fullness, frequent urination, constipation, pain with sex, and fatigue or breathlessness suggesting anemia. Sudden severe pelvic pain with fever needs urgent evaluation.
None of this is a recommendation for or against any particular procedure. Treatment for fibroids is highly individual, and the right answer depends on symptoms, anatomy, age, and whether childbearing is complete.
Key Questions Answered
What did Michelle Le disclose? That she had a hysterectomy in May after years of severe uterine fibroids, that she can no longer carry a pregnancy, and that she and her husband plan to look into surrogacy this fall.
How common are fibroids? They affect up to 80 percent of Black women and 70 percent of white women by age 50. About one in three women with fibroids has symptoms that affect daily life.
Do fibroids always affect fertility? No. Location matters more than size. Fibroids that distort the uterine cavity or block the fallopian tubes are the ones most likely to interfere with conception.
What are the alternatives to hysterectomy? Myomectomy preserves the uterus and is standard for patients wanting future pregnancy. Uterine artery embolization, radiofrequency ablation, and focused ultrasound are less invasive, with less established fertility data.
Why do some women still end up with a hysterectomy? Fibroids recur frequently, with one study finding 53 percent recurrence within five years and 84 percent within eight. Severe or repeated cases can exhaust uterus-sparing options.
Is pregnancy possible after a hysterectomy? Not by carrying one. A genetically related child remains possible through gestational surrogacy if the ovaries are intact or eggs or embryos were frozen beforehand.
When should someone see a doctor? Heavy bleeding, bleeding between periods, pelvic pressure, frequent urination, constipation, pain with sex, or fatigue suggesting anemia. Sudden severe pelvic pain with fever needs urgent care.
