The fallopian tubes play an essential role in pregnancy. They are a pair of tubes through which the eggs travel from the ovaries to the uterus. Each month, during ovulation in the menstrual cycle, one of the ovaries releases an egg that travels through one of the fallopian tubes, where it may or may not be fertilised by a sperm.
One of the most frequently asked questions, especially after tubal ligation, is whether it is possible for a woman to become pregnant without fallopian tubes.
The answer is yes: it is possible to become pregnant without tubes, thanks to advances in reproductive medicine such as in vitro fertilisation (IVF).
In this article, we will try to answer the different possibilities.
What is tubal ligation and can it be reversed?
There are many contraceptive methods on the market, but the most reliable and definitive contraceptive methods are vasectomy for men and tubal ligation for women.
Many patients who undergo these operations, for different reasons, may regret it in the future and may want to conceive a child again. In these cases, these patients must resort to reproductive medicine.
Tubal ligation is a permanent female sterilisation procedure that involves blocking or cutting the fallopian tubes, which connect the uterus to the ovaries, preventing natural fertilisation.
Reversal is performed on patients who wish to regain their fertility. During this process, the blocked segments of the fallopian tubes are reconnected using absorbable sutures, with the aim of reopening the tube channel so that the eggs released by the ovary can be captured and transported to the uterus, where they can be fertilised by the sperm travelling upwards to form an embryo.
The success or failure of a tubal ligation reversal will depend on:
- The age of the patient.
- The length of the remaining healthy tube.
- The degree of damage caused to the tube.
- The technical procedure that was used.
Thus, ‘ligation’ methods that cause less damage to the fallopian tubes have a higher probability of success in reversal, while sterilisation with tubal rings (such as the Essure system) or electrocautery are not usually reversible.
Is tubal reversal safe?
Like all surgery, tubal reversal involves certain risks:
- Injury to nearby organs
- Infection or bleeding
- Failure to reconnect the tubes
- Increased risk of ectopic pregnancy
In many cases, the most effective and least invasive alternative is to opt directly for in vitro fertilisation (IVF).
Is it possible to achieve a natural pregnancy without a fallopian tube?
Yes, you can get pregnant with only one fallopian tube if you meet any of the following criteria:
- You have at least one functioning ovary.
- You have monthly menstrual cycles (ovulation).
- The fallopian tube you have is healthy.
If you are unable to become pregnant after trying, or if you have a known history of problems with your fallopian tube, consult your gynaecologist specialising in reproduction for an evaluation.
Can you get pregnant with only one fallopian tube?
If you have had a bilateral salpingectomy, meaning you have no fallopian tubes, you cannot get pregnant naturally.
If you have had a tubal ligation, there is the possibility of undergoing tubal reversal surgery. However, the success of the procedure will depend on the type of ligation the doctor performed at the time.
It is essential that the distal part of the tubes (the ends near the ovary) remain viable and that they are at least four centimetres long so that they have not lost their functionality and can be recanalised with tubal reversal surgery.
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If the technique used at the time was Essure (withdrawn from the market in 2017), then reversal would not be possible.
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If the technique used was cauterisation, the fallopian tube is almost completely damaged, making recanalisation impossible.
How to get pregnant without fallopian tubes?
In the case of a bilateral salpingectomy (removal of both fallopian tubes), natural pregnancy is not possible. But that does not mean you cannot become a mother.
🔬 The best alternative is in vitro fertilisation (IVF), a technique that allows the egg to be fertilised in the laboratory and the embryo to be transferred directly to the uterus, without the need for fallopian tubes.
How to get pregnant without fallopian tubes?
The most effective option is IVF (in vitro fertilisation). This procedure is recommended for women with damaged, tied or absent fallopian tubes.
Advantages of IVF:
✔️ No surgery is required to reverse the ligation
✔️ Higher success rate than reversal surgery
✔️ Avoids the risk of ectopic pregnancy
✔️ Allows the use of egg donation if egg quality is low
Why do fallopian tubes become damaged?
When a woman has an ectopic pregnancy, i.e. outside the womb, the fallopian tubes can become damaged.
Furthermore, tubal disease accounts for almost 40% of female infertility. The assessment of the tubal factor is part of the initial study of the infertile couple. It is important to note that there is no test available to check tubal function.
The accumulation of fluid in the fallopian tubes, known as hydrosalpinx, can also cause damage and blockages.
In the basic study of an infertile couple, if no tubal pathology is suspected when taking the medical history and performing a transvaginal ultrasound, and in vitro fertilisation is indicated as an assisted reproduction technique, no additional studies of tubal patency are required.
You may only have one fallopian tube if you have had pelvic surgery in the past for an infection, tumour, or ectopic pregnancy. Occasionally, some women are born with only one fallopian tube.
Some of the most common causes are:
- Ectopic pregnancy
- Pelvic infections or pelvic inflammatory disease (PID)
- Previous surgery in the pelvic area
- Tumours or endometriosis
- Hydrosalpinx: fluid build-up that affects the functionality of the tube
- Previous ligation as a method of contraception
Sometimes women are born with only one tube, or it may have been lost without their knowledge following surgery or a complication.
Book a free consultationDo you have any questions or need more information?
At Fertility Madrid, we are specialists in treatments such as egg donation, in vitro fertilisation (IVF), and artificial insemination, among others.
Do not hesitate to contact our professionals at our fertility clinic — they will be happy to answer all your questions with no obligation.
Óscar Oviedo
Director Médico
