Your chances of getting pregnant after having a fallopian tube removed depend entirely on whether you lost one tube or both. With one tube removed, natural pregnancy is still possible. With both tubes removed, natural conception is essentially impossible, but IVF offers real options with live birth rates ranging from about 29% to 53% depending on your age and timing.
One Tube Removed: Natural Pregnancy Is Still Possible
If you had a unilateral salpingectomy (one tube removed), you can still get pregnant naturally as long as your remaining tube is healthy and functioning. Your ovaries still release eggs on both sides each month, and the remaining tube can sometimes pick up an egg released from the opposite ovary. Many women conceive without any fertility assistance after losing one tube.
That said, having one tube instead of two does reduce your chances compared to someone with both tubes intact. The egg has to travel a longer or less direct path in some cycles, and any existing damage or blockage in the remaining tube further lowers the odds. If you’ve been trying for six months to a year without success, fertility evaluation of that remaining tube is a reasonable next step.
Both Tubes Removed: IVF Becomes the Path Forward
When both fallopian tubes are removed (bilateral salpingectomy), there’s no way for an egg to travel from the ovary to the uterus on its own. Natural conception is virtually impossible. IVF bypasses the tubes entirely by retrieving eggs directly from the ovaries, fertilizing them in a lab, and placing the embryo into the uterus.
For women who had both tubes removed due to a condition called hydrosalpinx (fluid-filled, damaged tubes), IVF success rates are encouraging. In a large study of over 1,600 women who had bilateral salpingectomy before IVF, the clinical pregnancy rate after a first embryo transfer was about 43%, with a live birth rate around 36%. Over multiple transfer cycles, those numbers climb higher, particularly for younger women.
Why Removing Damaged Tubes Can Improve IVF Outcomes
This is one of the more counterintuitive facts about tubal removal: if your tubes were damaged or filled with fluid, removing them before IVF actually improves your chances of success. Diseased tubes can leak toxic fluid into the uterus, interfering with embryo implantation. Removing them first resulted in a delivery rate of 28.6% versus 16.3% when the damaged tubes were left in place. For women with visible fluid buildup in both tubes on ultrasound, the benefit was even more dramatic, with live birth rates increasing nearly fourfold after removal.
So if your salpingectomy was performed to treat a tubal disease before fertility treatment, the surgery itself was likely a step toward better odds, not worse ones.
Age Makes a Significant Difference
Age is the single biggest factor influencing IVF success after bilateral salpingectomy. In the same large study, women under 35 who had their tubes removed before egg retrieval achieved accumulated live birth rates of 52.5% over multiple cycles. Women 35 and older saw accumulated live birth rates closer to 29%, though accumulated pregnancy rates still reached 38%.
This age gap isn’t unique to women who’ve had tubes removed. It reflects the natural decline in egg quality and quantity that affects all fertility treatment. But it does mean that if you’re planning IVF after bilateral salpingectomy, earlier treatment generally translates to better outcomes.
Timing Between Surgery and IVF Matters
How long you wait between tube removal and starting IVF can affect your results. Research shows a sweet spot: women who began egg retrieval 4 to 12 months after salpingectomy had significantly higher pregnancy and live birth rates compared to those who started sooner. Starting IVF within the first few months after surgery may not give the body enough time to recover, while waiting too long (beyond 12 months) didn’t offer additional benefit.
If you’re planning IVF after salpingectomy, aiming for that 4 to 12 month window gives your body time to heal while keeping your age-related fertility window in play.
Does Tube Removal Affect Ovarian Reserve?
One concern worth knowing about: salpingectomy may slightly reduce ovarian reserve, which is the supply of eggs your ovaries have available. A study of 198 women found that those who had bilateral salpingectomy showed lower levels of a key fertility hormone (AMH, which reflects remaining egg supply) and higher levels of FSH (which rises as egg supply drops) compared to women who hadn’t had tubal surgery.
However, this hormonal change didn’t necessarily translate into fewer eggs retrieved during IVF. The number of eggs collected wasn’t correlated with those hormone levels in women who’d had salpingectomy. In practical terms, this means the surgery may shift your hormone markers without necessarily reducing how well IVF works for you. It’s still worth discussing with a fertility specialist, particularly if you already have concerns about low ovarian reserve.
Bilateral Salpingectomy as Permanent Contraception
Some readers searching this question may have had both tubes removed specifically for sterilization and are now wondering if pregnancy could still happen. The short answer: it’s extraordinarily unlikely. A systematic review comparing salpingectomy to traditional tubal ligation found that complete tube removal had a lower pregnancy rate than ligation (where the tubes are cut, tied, or clipped but not fully removed), though the difference was not statistically significant because pregnancies after either procedure are so rare. Complete removal leaves no tubal tissue for an egg to pass through, making it the most reliable form of permanent contraception available.
If you’ve had a bilateral salpingectomy for sterilization and later change your mind about having children, IVF is your only realistic option. Unlike tubal ligation, there’s no reversal procedure possible when the tubes have been entirely removed.