Natural pregnancy after having both fallopian tubes removed is essentially impossible. A study of over 1,000 patients who underwent bilateral salpingectomy found a 0% to 0.3% pregnancy rate over five years, and the few positive home tests in that study all turned out to be false positives when confirmed in a clinic. However, pregnancy through IVF remains a viable option because the procedure bypasses the fallopian tubes entirely.
Why Natural Conception Won’t Happen
Your fallopian tubes are the only pathway an egg can travel from the ovary to the uterus. They’re also where sperm meets egg for fertilization. When both tubes are completely removed (a procedure called bilateral salpingectomy), there is no channel left for sperm and egg to meet, and no way for a fertilized egg to reach the uterus.
This is different from having your tubes “tied.” Tubal ligation clips, cuts, or blocks the tubes but leaves them in place. Over time, a tied tube can occasionally reconnect or develop a small opening, which is why tubal ligation carries a failure rate around 1.3% over ten years. Complete removal eliminates that possibility. A meta-analysis comparing the two procedures found that salpingectomy had a lower pregnancy rate than tubal ligation, and researchers now consider it the more effective form of permanent sterilization.
IVF After Tube Removal
In vitro fertilization is the primary path to pregnancy after bilateral salpingectomy. IVF works by retrieving eggs directly from your ovaries, fertilizing them with sperm in a lab, and then transferring the resulting embryo into your uterus. The fallopian tubes are never involved, which is exactly why IVF was originally developed for people with blocked or damaged tubes.
If your tubes were removed because of a condition called hydrosalpinx (fluid-filled, swollen tubes), removing them before IVF actually improves your chances. Hydrosalpinx reduces IVF success, implantation, and pregnancy rates by about 50% and doubles the miscarriage rate. Several studies have found that salpingectomy before IVF significantly increases pregnancy rates in these cases.
When to Start IVF After Surgery
Timing matters. Research on patients who had both tubes removed for hydrosalpinx found that starting IVF too soon after surgery led to lower success rates. Patients who began egg retrieval 4 to 12 months after their salpingectomy had significantly higher pregnancy and live birth rates compared to those who started within three months. The sweet spot appears to be waiting roughly 4 to 6 months, giving your body time to heal without waiting so long that other age-related factors come into play.
If you’re using frozen embryos rather than starting a fresh IVF cycle, the timing is more flexible. Studies found no significant difference in pregnancy outcomes regardless of when frozen embryo transfer happened after surgery.
Will Tube Removal Affect Your Fertility for IVF?
A common concern is whether removing the tubes damages blood supply to the ovaries and reduces your egg reserve. The ovaries and fallopian tubes share some of their blood supply, so this isn’t an unreasonable worry. However, most research is reassuring. A systematic review of studies on this topic found no relationship between tube removal and impaired ovarian blood flow in the short term. Hormone levels that reflect egg reserve, including AMH and FSH, generally stayed stable after surgery in studies tracking patients for up to five years.
One study did find a temporary dip in ovarian reserve markers at three months after surgery, but other studies measuring the same markers at six months and beyond found no lasting differences. The current evidence suggests your ovaries will continue functioning normally after the procedure, though some researchers note that long-term effects beyond five years haven’t been fully studied.
The Rare Exception: Interstitial Ectopic Pregnancy
Even after complete tube removal, a tiny stub of each tube remains where it connects to the uterus. This section, called the interstitial portion, is embedded in the uterine wall and can’t be fully removed without damaging the uterus itself. In extremely rare cases, an embryo (usually transferred during IVF) can implant in this small remnant.
This type of pregnancy is not viable and is considered a medical emergency. The interstitial segment has a rich blood supply, making rupture particularly dangerous. Case reports of this happening after bilateral salpingectomy do exist, but they are vanishingly rare. It’s worth being aware of, especially if you’re pursuing IVF, because early symptoms like sharp one-sided pain or unusual bleeding after embryo transfer warrant immediate evaluation.
Tubes Removed vs. Tubes Tied
If you’re reading this because you’re unsure which procedure you had, the distinction is important. “Getting your tubes tied” typically refers to tubal ligation, where the tubes are blocked but remain in your body. Pregnancy after tubal ligation, while uncommon, does happen, and tubal ligation can sometimes be reversed surgically. Bilateral salpingectomy, where the tubes are fully removed, is essentially irreversible. There is no reconnection surgery possible because there is nothing left to reconnect.
For someone with tied tubes, both reversal surgery and IVF are options for future pregnancy. For someone with removed tubes, IVF is the only realistic path. If you’re uncertain about your surgical history, your medical records or a pelvic ultrasound can clarify what was done.