Pregnancy is highly possible after the loss of an ovary and the corresponding fallopian tube, a condition known as unilateral adnexal loss. This loss does not typically eliminate the ability to conceive naturally, even when the remaining ovary and fallopian tube are contralateral (on opposite sides). The female body possesses a remarkable ability to adapt, allowing a woman with one healthy ovary and one healthy fallopian tube to maintain a strong potential for achieving pregnancy.
The Reproductive System’s Adaptability
The anatomical position of the fallopian tubes and ovaries is not fixed. The tubes and ovaries are mobile and lie close to each other within the pelvic space. This flexibility allows for contralateral ovum pick-up, or transperitoneal migration, which is the mechanism that allows for conception when the remaining ovary and tube are on opposite sides.
At the end of the fallopian tube are delicate, finger-like projections called fimbriae. These fimbriae become active near ovulation, sweeping close to the ovary’s surface. This motion helps capture the egg once it is released.
When ovulation occurs from the contralateral ovary, the egg enters the peritoneal cavity (the space within the abdomen). The fimbriae of the remaining tube can migrate across this space to retrieve the egg. The egg is drawn into the tube, where fertilization occurs before the embryo is transported to the uterus.
This migration ability confirms that the single remaining fallopian tube can effectively perform a “double-duty” role, collecting eggs from both the adjacent ovary and the ovary on the opposite side. The success of this process relies on the patency and overall health of the remaining tube, allowing for unimpeded egg transport. The adaptability of the pelvic organs ensures that the chance of conception is not necessarily halved.
Key Factors Affecting Fertility Rates
While the body’s anatomy is adaptable, the likelihood of conception is influenced by several specific variables beyond the presence of the organs. The most significant factor determining fertility potential is the woman’s age, which directly impacts the quality and quantity of the remaining eggs. Oocyte quality diminishes as a woman ages, and this decline accelerates after age 35.
The cause of the adnexal loss is a major consideration, as the underlying condition may have affected the health of the remaining structures. If the loss was due to a severe pelvic infection or endometriosis, the remaining fallopian tube may have microscopic damage or scarring that could impede its function. A damaged tube also increases the risk of a subsequent ectopic pregnancy.
The overall ovarian reserve, which is the total number and quality of eggs in the remaining ovary, is another important factor. While one ovary often compensates by producing a mature egg most cycles, having only one affects the Anti-Müllerian Hormone (AMH) level, a marker for the size of the remaining egg supply. Despite conflicting studies on the long-term impact of unilateral oophorectomy, many women with one ovary achieve a successful pregnancy.
The patency of the remaining fallopian tube is paramount for natural conception. The tube must be completely open and free of blockages or scar tissue to ensure the sperm can reach the egg and the fertilized embryo can travel safely to the uterus. Any compromise to the tube’s internal structure can significantly reduce the chances of a successful pregnancy.
When to Seek Fertility Assistance
Individuals with unilateral adnexal loss should be proactive about seeking professional evaluation. For women under 35, the standard recommendation is to try to conceive naturally for one year before consulting a specialist. If the woman is 35 or older, or if the loss was due to an underlying condition like endometriosis, seeking consultation after six months of unsuccessful trying is advisable.
Initial diagnostic steps focus on confirming the health and function of the remaining ovary and tube. A hysterosalpingogram (HSG) is a common procedure used to verify that the single fallopian tube is open. Blood work, including hormonal testing, assesses the ovarian reserve and confirms regular ovulation.
If natural conception proves difficult, several interventions are available. Mild treatments, such as ovulation induction using fertility medications, can stimulate the remaining ovary and increase the number of eggs released. Intrauterine insemination (IUI) may be combined with these medications to increase the concentration of sperm available for fertilization.
If these treatments are unsuccessful, or if the remaining tube is non-functional, In Vitro Fertilization (IVF) is a highly effective option. IVF completely bypasses the need for the fallopian tube. Eggs are retrieved directly from the ovary, fertilized in a laboratory, and the resulting embryo is placed directly into the uterus.