Yes, you can still get pregnant with only one fallopian tube. Most women in this situation conceive naturally, and studies show that roughly 64% to 76% of women achieve a pregnancy within two years of having a tube removed. Your chances depend on whether your remaining tube is healthy, whether you’re ovulating regularly, and your age.
How Pregnancy Works With One Tube
Each month, one of your ovaries releases an egg, and the egg travels through a fallopian tube toward the uterus. If sperm is present, fertilization happens inside the tube, and the fertilized egg then implants in the uterine wall. When one tube is missing, you might assume you can only conceive during months when the ovary on the same side as your remaining tube releases the egg. That’s not the case.
Research published in Human Reproduction found that approximately one-third of spontaneous pregnancies after tube removal resulted from the remaining tube picking up an egg released by the opposite ovary. This process, called ovum transmigration, means your single tube can reach across and collect eggs from either side. In a study of 842 pregnancies after tube removal, 31.6% showed clear evidence that the egg came from the ovary on the opposite side. So rather than being fertile only every other cycle, you have a chance of conceiving in most cycles.
Pregnancy Success Rates
Large studies tracking women after tube removal for ectopic pregnancy provide a realistic picture of what to expect. One study found a 55.5% intrauterine pregnancy rate within 24 months of tube removal. Another, which followed patients after different ectopic pregnancy treatments, found a two-year pregnancy rate between 64% and 76% depending on the treatment group. These numbers reflect natural conception without fertility assistance.
The range matters because individual factors play a significant role. Women with a healthy remaining tube and no other fertility issues tend to fall toward the higher end of that range. Those with underlying damage to the remaining tube, endometriosis, or age-related fertility decline may fall toward the lower end. Having one tube does reduce your odds compared to having two, but for most women, it doesn’t prevent pregnancy entirely.
Why You Might Have Only One Tube
The most common reason is an ectopic pregnancy, where a fertilized egg implants inside the tube instead of the uterus. When this happens, the tube often needs to be surgically removed to prevent life-threatening complications. Other reasons include ovarian cysts, benign tumors, abscesses that don’t respond to other treatment, and certain cancers. Some women are born with a single tube, though this is less common.
The reason your tube was removed can influence your fertility outlook. If the tube was removed because of an ectopic pregnancy, for instance, the remaining tube may share some of the same risk factors (such as prior infection or scarring) that contributed to the ectopic in the first place. If the removal was for a reason unrelated to tubal health, like an ovarian cyst on that side, the remaining tube is more likely to function normally.
Ectopic Pregnancy Risk After Tube Removal
If you lost your tube due to an ectopic pregnancy, the risk of another ectopic in your remaining tube is something to be aware of. Recurrence rates range from 10% to 27%, depending on whether the remaining tube shows signs of damage or abnormality. The condition of your contralateral tube at the time of the first ectopic pregnancy is one of the strongest predictors of recurrence.
This doesn’t mean you should avoid trying to conceive. It means that once you do get a positive pregnancy test, early monitoring is important. Your provider will likely want to confirm the pregnancy is in the uterus with an early ultrasound, typically around six weeks. Knowing your risk level helps you and your care team act quickly if something seems off.
What Affects Your Chances
Three factors matter most. First, your remaining tube needs to be open and functional. Scarring, adhesions, or fluid buildup (sometimes caused by prior infections or endometriosis) can block or damage the tube. A test called a hysterosalpingogram, which uses dye and X-ray to visualize the tube, can confirm whether it’s open.
Second, you need to be ovulating. If you have regular menstrual cycles, you’re almost certainly ovulating. Irregular or absent periods suggest something else may be interfering with ovulation, which is a separate issue from having one tube.
Third, age plays a major role. Egg quality and quantity decline over time, particularly after 35. This decline affects all women, but when you’re already working with a single tube, age-related changes can compound the challenge.
When to Seek Help
Because having a single tube is a known risk factor for reduced fertility, you may not need to wait as long as someone with two tubes before getting evaluated. The American Society for Reproductive Medicine recommends that women with known or suspected tubal issues can start diagnostic testing without the standard waiting period. For context, the general guideline is to seek evaluation after 12 months of trying if you’re under 35, or after 6 months if you’re 35 or older. Women over 40 may benefit from even earlier evaluation.
If natural conception doesn’t happen within your expected timeframe, IVF bypasses the fallopian tubes entirely by fertilizing eggs outside the body and transferring embryos directly into the uterus. This makes it a particularly effective option for tubal-factor infertility. But many women with one healthy tube conceive without any assistance, so fertility treatment isn’t a given, just an option if needed.