If the uterus is surgically removed, which of the following reproductive processes is most significantly affected?

If the uterus is surgically removed (a procedure known as hysterectomy), the most affected process among the options provided would be implantation. Implantation is the process by which a fertilised egg (zygote) attaches to the lining of the uterus (endometrium) and begins to grow and develop into an embryo.

Without a uterus, there is no viable site for implantation to occur. Therefore, even if oogenesis (formation of eggs), ovulation (release of ovum), and insemination (introduction of sperm into the female reproductive tract) were to occur, the absence of a uterus would prevent implantation and subsequent pregnancy from taking place.