Updated by the Progyny Clinical Team — December 2025.
Treatment for tubal factor infertility typically involves surgery and/or in vitro fertilization (IVF), which bypasses the fallopian tubes. The choice depends on the location and severity of tubal damage, as well as individual factors such as age, ovarian reserve, sperm quality, and other infertility diagnoses.
IVF
IVF bypasses the fallopian tubes entirely and is often preferred when tubal disease is severe or unlikely to be successfully repaired. IVF success rates are generally reported per cycle, and many people achieve pregnancy without undergoing surgery. However, for patients with a dilated fallopian tube, called a hydrosalpinx, surgery may be recommended to improve success with IVF. IVF involves medication injections, monitoring, and a minor outpatient procedure to remove eggs from the ovary, which are then fertilized in a laboratory.
Though rare, there are rare risks that can occur with IVF. These include ovarian hyperstimulation syndrome, bleeding, infection, ovarian torsion, and damage to nearby structures. The risk of complication is less than 1%.
Surgical options
Surgery may be appropriate for select patients, particularly younger women without other infertility factors. Common surgical approaches include:
- Selective tubal cannulation: Can open a blockage near the uterus (proximal obstruction).
- Laparoscopic fimbrioplasty or neosalpingostomy: Can treat mild distal tubal disease or mild hydrosalpinx.
- Laparoscopic salpingectomy: Recommended for severe or irreparable hydrosalpinx before IVF, as removing the damaged tube improves implantation and pregnancy rates.
- Tubal reversal (after prior sterilization): Microsurgical procedures may restore fertility in carefully selected patients.
Surgery vs. IVF
Direct comparisons of pregnancy rates between tubal surgery and IVF are limited. Surgery may restore natural fertility over time, while IVF typically offers higher per-cycle success rates and avoids some surgical risks. Your fertility team can help evaluate which approach makes sense based on your unique situation.
Deciding on treatment
When choosing between surgery and IVF, consider:
- Your age and ovarian reserve
- Sperm count and quality
- Desired family size
- Location and severity of tubal disease
- Other infertility factors
- Risk of ectopic pregnancy or complications
- Your doctor’s experience
- IVF program success rates and cost
- Personal preferences
Your care team can help weigh these factors and guide you toward the treatment path most aligned with your goals.
If you have questions, Progyny is here for you. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.