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What do I need to know about conceiving after surgery on my Fallopian tubes?

This fact sheet was developed in collaboration with The Society of Reproductive Surgeons.

Updated 2023


Fallopian tubes connect the ovary (where eggs are stored and grow) to the uterus (womb), where a fertilized egg develops into a baby (fetus). Fertilization is the joining of an egg and sperm and normally takes place in the fallopian tube. If a fallopian tube is blocked or damaged, this can prevent a woman from getting pregnant and increase the risk of becoming pregnant in the fallopian tube (a “tubal” or “ectopic” pregnancy). Surgery may be performed to open and repair blocked or damaged tubes.

What could damage my fallopian tubes?

An infection or surgery in the abdomen or pelvis can cause blockage of tubes by forming adhesions (scars). These adhesions can be between the end of the tube and the ovary or inside the tube and may completely block the tube. Two common sexually transmitted infections (STIs) that can damage tubes are chlamydia and gonorrhea. Occasionally, non-STI infections can cause tubal damage. For instance, tuberculosis can cause tubal disease (although it is very uncommon in North America). Tubal damage can also be caused by the rupture (bursting) of the appendix. Any surgery in the abdomen or pelvis can also cause scar tissue, including common surgeries like removing fibroids or operations for ovarian cysts.

In addition, endometriosis is a common gynecologic condition that can be associated with damage to your tubes. Women who have pelvic pain (pain during sex or painful periods) and who are also having trouble getting pregnant may be at risk of endometriosis.

How can a damaged tube be fixed?

Success of surgery on tubes depends on where the tube is blocked and the severity of the damage. Different surgical techniques are used depending on the location of the tubal blockage. The goal of surgery is to open the tubal passage by either removing scar tissue, creating a new opening in the outside of the tube (closest to the ovary), or opening up the tube from the inside (cannulation).

If the blockage is at the end of the tube closest to the ovary, then surgery is performed either with:

  • Laparoscopy (a camera is placed through a tiny incision through your belly button)
  • Laparotomy (traditional open surgery performed through a much larger incision made in your abdomen [belly]).

Both the surgeries are performed under anesthesia. If the tubal blockage is inside the tube closest to the uterus, then hysteroscopy (a camera placed through your cervix and into your uterus) is used to place a tiny tube (cannula) past the blockage. This is typically done along with laparoscopy (see ASRM booklet titled Laparoscopy and Hysteroscopy).

Will I be able to get pregnant?

The chance of becoming pregnant after tubal surgery depends on 3 factors: the amount of damage to the tubes, the health of the partner’s sperm, and the age of the woman. If the tubes are badly damaged or remain blocked even after surgery, a woman may be able to get pregnant through in vitro fertilization (IVF) (see ASRM fact sheet titled In vitro fertilization [IVF]). In IVF treatment, eggs and sperm are collected and joined outside the body in a laboratory. After 3-5 days, the healthiest fertilized eggs (now called embryos) are placed into the woman’s uterus where they can grow into a pregnancy. If the partner’s sperm count is low, going straight to IVF may be recommended because it treats both tubal disease and low sperm count.

What are the risks of tubal surgery?

The biggest risk after tubal surgery is the possibility of a tubal pregnancy, also known as an ectopic (outside the uterus) pregnancy (see ASRM fact sheet and booklet titled Ectopic Pregnancy). Ectopic pregnancy can be very dangerous to the mother. It is important for women with tubal disease/blocked tubes or women who have had tubal surgery to see a healthcare provider as soon as they think they are pregnant or have missed their period to be evaluated for an ectopic pregnancy before it causes serious complications. Irregular vaginal bleeding and lower abdominal pain are common symptoms associated with tubal pregnancy, particularly at later stages. If left untreated, tubal pregnancies can burst and cause internal bleeding and possibly death of the mother.

Other risks related to surgery for blocked tubes are the same as with any surgery and include the possibility of bleeding; damage to other organs (body parts) such as blood vessels, your bladder, and bowel (gut); development of new scar tissue; a reaction to the anesthesia; and the need for a blood transfusion.

If you have... Your chance of getting pregnant after surgery is...
Very few adhesions (scars) between the tubes and ovaries, and your tubes otherwise look healthy Fairly good
Lots of thick adhesions between the tubes and ovaries and/or the walls of the tubes look thick and rubbery Not good; IVF may be the best treatment to help you get pregnant
Only 1 tube is blocked, the other tube is healthy, and the walls of your tube look normal Fairly good
A blocked tube that is filled with fluid (hydrosalpinx), and the walls of your tubes look thin Not good; IVF may be the best treatment to help you get pregnant. The damaged tube can be treated/removed to increase your chances of getting pregnant with IVF treatment.

You should discuss with your healthcare provider whether surgery or other treatment, such as IVF, is appropriate for you based on your situation.

Laparoscopy

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Conditions Treated with Surgery on the Fallopian Tubes and Ovaries

Surgery can be used to treat problems with the ovaries or fallopian tubes, such as cysts, endometriosis, or infections. View the Fact Sheet
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Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
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Laparoscopy and Hysteroscopy

Laparoscopy and hysteroscopy can be used for both diagnostic (looking only) and operative (looking and treating) purposes. View the booklet
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Treatment of uterine fibroids

Do all fibroids require treatment? Not usually, because most patients with fibroids do not have symptoms. View the fact sheet
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Hydrosalpinx

The fallopian tubes are attached to the uterus (womb) on the left and right sides. View the Fact Sheet
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Minimally invasive surgery

Surgery is termed “minimally invasive” if it uses small or no incisions (cuts). View the fact sheet
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Ovarian drilling for infertility

Often, women with polycystic ovary syndrome (PCOS) do not have regular menstrual periods. View the fact sheet
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Robotic Surgery

Robotic surgery is a form of laparoscopy. View the fact sheet
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Endometriosis (booklet)

Women with endometriosis may experience infertility, pelvic pain, or both. This booklet will describe options for diagnosing and treating pain or infertility that may be attributed to endometriosis. View the Booklet

Endometriosis

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Managing Pelvic Pain

Many women have pain in their pelvis (lower part of the belly) from time to time, usually during their period. View the fact sheet
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SART Fertility Experts - Endometriosis

Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility.   Listen to the Episode
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Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
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Endometriosis: Does It Cause Infertility?

When tissue like the tissue that normally lines the inside of the uterus (endometrium) is found outside the uterus, it is termed “endometriosis.” View the Fact Sheet
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Hydrosalpinx

The fallopian tubes are attached to the uterus (womb) on the left and right sides. View the Fact Sheet
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Endometriosis

Endometriosis is a condition in which endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations. Watch Video
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Causes of Female Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
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Endometriosis (booklet)

Women with endometriosis may experience infertility, pelvic pain, or both. This booklet will describe options for diagnosing and treating pain or infertility that may be attributed to endometriosis. View the Booklet
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Endometriosis and Infertility: Can Surgery Help?

Endometriosis is when tissue is found outside the uterus that appears similar to the lining of the uterus (endometrium). Endometriosis may grow on the outside of your uterus, ovaries, and tubes and even on your bladder or intestines. This tissue can irritate structures that it touches, causing pain and adhesions (scar tissue) on these organs. View the Fact Sheet
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Noncontraceptive Benefits of Birth Control Pills

Most women will use birth control pills at some time in their lives. View the fact sheet
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Endometriosis Infographics

ASRM has prepared infographics to illustrate the subject of Endometriosis better. View the Infographics

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
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Hormonal Contraception

Hormonal contraceptives contain a progestin (progesterone medicine) with or without an estrogen.
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Third-Party Reproduction

The phrase “third-party reproduction” refers to involving someone other than the individual or couple that plans to raise the child (intended parent[s]) in the process of reproduction.
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Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
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Stress and infertility

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