There are several types of surgery to fix blocked fallopian tubes. The type of surgery you have will depend on the type of blockage, where it is, and how bad it is. Surgery may be done to:
These surgeries are usually done through a small incision (laparoscopically).
The success of fallopian tube surgery depends in part on the location and extent of the blockage. It may also depend on whether you have other fertility problems or pelvic conditions. Talk to your doctor about his or her success rates with any procedure you are considering.
Fallopian tube surgery may or may not lead to a healthy pregnancy. About 7 to 9 out of 100 women who get pregnant after fallopian tube surgery have an ectopic (tubal) pregnancy, which can be dangerous. This means that 91 to 93 out of 100 women who have the surgery don't have an ectopic pregnancy. These pregnancies usually happen because of tubal damage the women already had before surgery, rather than because of the surgery itself.1
For women age 35 or older, perhaps the greatest risk is the time it takes to recover from surgery and then try to get pregnant. If you want to try only tubal surgery, the sooner you begin, the better. If you are thinking about having IVF with your own eggs, you may want to start IVF as soon as possible, rather than having surgery.
During in vitro fertilization (IVF), a woman's eggs are mixed with a man's sperm in a lab. The resulting embryo or embryos are then transferred into the uterus. Your doctor can use your eggs and sperm for IVF, or you can try donor eggs or sperm if needed.
Most women begin the IVF process by having daily hormone shots to grow multiple eggs. This is called superovulation. The eggs are then collected, either through a needle guided by ultrasound or laparoscope. The best-quality eggs are fertilized with sperm, and the best embryos are implanted in the uterus. Then you have a series of hormone shots to support the first days of pregnancy.
Some women choose to use their own eggs naturally and not use superovulation.
In vitro fertilization (IVF) was first used for women with no fallopian tubes. Now this procedure is also used to treat couples whose infertility is caused by:
The success of IVF depends on many different things, including age, the cause of infertility, whether the woman has given birth before, and whether the woman's own eggs or donor eggs are used. Talk to your doctor about what to expect based on these and other factors.
In vitro fertilization (IVF) is emotionally and physically demanding. You need to have several procedures to produce and collect eggs and then to implant embryos. IVF increases the risks of:
If you choose IVF, talk to your doctor about how to reduce your risk of multiple pregnancy.
Your doctor might recommend surgery on your fallopian tubes if:
Your doctor might recommend IVF if:
|Have tubal surgery||Have IVF|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"Since we learned that I have blocked fallopian tubes, we've been going back and forth about what to do. Time is ticking away, so we need to act soon. I've decided that I'm willing to have surgery and keep trying to conceive for a year. My hormone tests tell me that I'm still fertile, and who knows—maybe we could actually have more than one child after fixing the problem. If not, we're considering adopting."
— Karen, age 36
"I was shocked to learn that my fallopian tubes were so badly damaged by the chlamydia infection I had a few years ago. My doctor says that we can try surgery to repair the tubes, but that my best bet is trying in vitro fertilization. We can't possibly afford in vitro fertilization, and we're lucky that my provincial health plan will cover the surgery, so I'm going to have the surgery and see if it helps."
— Marianna, age 26
"Now that we're ready to have a child, we're really ready! We don't care what it takes. Our doctor tells us that in vitro fertilization is really our only choice, considering my age. By the time I have my tubes repaired and start trying to get pregnant, I'll be too old to have any other options if that doesn't work. So, we're going to go for it and do the in vitro fertilization. We figure we'll try it three times and hope one of them takes."
— Teri, age 39
"I'm told that I have a small blockage in one of my fallopian tubes that can be treated without surgery. The doc says she can put a little plastic catheter in my fallopian tube to open up the blockage, and I have a good chance of getting pregnant after that."
— Anne, age 30
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery
Reasons to have IVF
I want to have surgery and then wait and see if I can get pregnant.
I don't want to take the time to see if surgery will work.
I don't want to go through a fertility treatment each time I want to get pregnant.
I want to get pregnant as soon as possible, even if I have to do IVF each time I want to get pregnant.
I'm scared of having a bad problem from the hormones in IVF.
I'm not worried about side effects from taking hormones.
I don't mind paying for the one-time cost of surgery.
I'm worried about the cost of IVF. I can't afford to have IVF each time I want to get pregnant.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
1. Which treatment can fix a problem with your fallopian tubes?
2. Which treatment might your doctor recommend if you are 35 or older?
3. Which treatment guarantees that you can get pregnant?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology|
Centers for Disease Control and Prevention, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology (2008). 2008 Assisted Reproductive Technology Success Rates: National Summary and Fertility Clinic Reports. Available online: http://www.cdc.gov/art/ART2008/PDF/ART_2008_Full.pdf.