Without fallopian tubes, the chance of getting pregnant naturally is essentially zero. Fallopian tubes are where sperm meets egg and where fertilization happens, so removing both tubes (a bilateral salpingectomy) eliminates the natural pathway to pregnancy. However, in vitro fertilization (IVF) bypasses the tubes entirely, making pregnancy very much possible for people in this situation.
Why Natural Pregnancy Is Nearly Impossible
In a typical menstrual cycle, an ovary releases an egg that travels into the fallopian tube. Sperm swim up through the uterus and into the tube, where fertilization occurs. The fertilized egg then spends several days traveling down the tube before implanting in the uterine lining. When both fallopian tubes are removed, there is no channel connecting the ovaries to the uterus, so the egg has no way to meet sperm and no way to reach the uterus.
That said, “nearly impossible” is not the same as “absolutely impossible.” A single confirmed case of spontaneous pregnancy after bilateral salpingectomy exists in the English-language medical literature, reported in the journal Fertility and Sterility. Doctors believe the pregnancy occurred because the tiny opening where the tube once connected to the uterus (the cornual end) remained slightly open, allowing either sperm to reach the egg or a fertilized egg to enter the uterus from the abdominal cavity. This is so extraordinarily rare that it should not be considered a realistic possibility.
How IVF Changes the Picture
IVF was originally developed for exactly this situation. The procedure collects eggs directly from the ovaries using a needle guided by ultrasound, fertilizes them with sperm in a lab, and then places the resulting embryo directly into the uterus. The fallopian tubes play no role at any stage. Your ovaries still function normally after a salpingectomy, continuing to release hormones and produce eggs each cycle, so egg retrieval works the same as it would for anyone else.
IVF success rates depend on age, egg quality, and other fertility factors, not on whether you have fallopian tubes. For people under 35, IVF success rates per embryo transfer cycle are roughly 40 to 50 percent. Those rates decline with age, dropping to around 10 to 15 percent for people over 40. In some cases, removing damaged or fluid-filled tubes before IVF actually improves success rates, because fluid from unhealthy tubes can leak into the uterus and interfere with implantation.
Ectopic Pregnancy Risk Still Exists
One thing that surprises many people is that ectopic pregnancy (a pregnancy that implants outside the uterus) can still happen even after both tubes are removed. It is rare, but not unheard of, particularly with IVF.
When a salpingectomy is performed, a small stump of tissue where the tube once attached to the uterus can remain. In rare cases, an embryo can implant in that stump. These “tubal stump ectopic pregnancies” are difficult to diagnose because doctors may not expect an ectopic pregnancy on the side where a tube was previously removed. If the stump implantation goes undetected, it can rupture and cause serious internal bleeding requiring emergency surgery.
There is also a slightly elevated risk of heterotopic pregnancy during IVF, where one embryo implants normally in the uterus while another implants in an abnormal location. The incidence of heterotopic pregnancy has risen from about 0.03 percent to 1 to 3 percent with assisted reproductive techniques. Nearly 20 ectopic pregnancies after IVF have been reported in patients with previous bilateral salpingectomy, and one fertility center documented five such cases over eight years. These numbers are small in absolute terms, but they mean the risk is not zero.
What You Can Expect Going Forward
If you’ve had both fallopian tubes removed and want to become pregnant, IVF is your path. The process typically begins with hormone injections over 10 to 14 days to stimulate the ovaries to produce multiple eggs. After retrieval, fertilization, and a few days of embryo development in the lab, one or two embryos are transferred into the uterus. A pregnancy test follows about two weeks later.
Most people need more than one cycle. Some choose to freeze embryos from the first retrieval and transfer them one at a time across multiple cycles, which can reduce costs and physical demands compared to repeating the full stimulation process. The total timeline from first consultation to a confirmed pregnancy varies widely, but three to six months is common for people who respond well to treatment.
Having no fallopian tubes does not affect your ability to carry a pregnancy once an embryo implants. The uterus functions independently of the tubes, and pregnancies achieved through IVF after salpingectomy are monitored and managed the same way as any other pregnancy. Your ovaries also continue producing estrogen and progesterone on their own, so removing the tubes does not trigger early menopause or hormonal changes.