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  » Infertility  »  Surgical treatment for tubal factor infertility


Hydrosalpinx, a blocked right fallopian tube prior to surgical repair
The end of the tube is stuck in pelvic scar tissue to the ovary

Background

Tubal factor infertility accounts for about 20-25% of all cases of infertility.

The treatment for tubal factor infertility is usually either tubal surgery to repair some of the damage or in vitro fertilization (IVF).

The pros and cons of surgery versus IVF are discussed on the tubal factor infertility page.

The pros and cons of tubal reversal surgery versus IVF for women who have had their tubes tied, clipped, or burned are discussed on the tubal reversal versus IVF page.

Laparoscopy and laparotomy

Laparoscopic repair of a blocked fallopian tube (neosalpingostomy)
Grasping instrument is holding end of tube at newly created opening, "O"

Many tubal surgeries can be performed laparoscopically ("belly-button" or "Band-Aid" surgery). This allows the woman to go home the same day, return to work in 3-4 days, and have only small scars (each less than 1") on her abdomen.

However, not all tubal surgeries can be performed as well through the laparoscope as by laparotomy (bigger incision - about 4 inches long). This also depends on the skill and training of the surgeon.

Pregnancy rates and ectopic pregnancy rates after tubal surgery

According to published studies, approximate pregnancy rates by 12 months after tubal surgery are shown below. These numbers are average figures from a group of women that have had tubal surgery. In real life, each case is unique and should be assessed individually.

Type of surgery

Medical terminology

Pregnancy rate

Tubal pregnancy rate

Reconstruct damaged end of tube

Fimbrioplasty

50% over 1-2 years

12% of pregnancies

Cut away scar tissue on tubes
or on ovary

Salpingolysis

Ovariolysis

45% over 1-2 years


6% of pregnancies

Make opening in blocked tube

Neosalpingostomy

25% over 1-2 years

25% of pregnancies

Reconnect tubes after tubal ligation

Tubal reanastomosis

50-70% over 1-2 years

4-15% of pregnancies

In vitro fertilization 
(for comparison)

IVF

50-60% per attempt at our clinic
(age < 35, blocked tubes)
Our IVF pregnancy rates

1-5% of pregnancies
(women with blocked tubes)