Should I unblock my fallopian tube before IVF?

Doctor's Answers 2

Photo of Dr Paul Tseng
Dr Paul Tseng


We used to resort to surgery to unblock damaged and obstructed tubes. This was a time when IVF was in its infancy and results unpredictable. The situation has since changed for the better.

IVF results are much better and the discomfort much less than undergoing surgery to unblock a tube.

It is also now not recommended as first line treatment as the damaged tube would most likely have many areas of damage and blockages that it would be very difficult to retain a healthy portion of the tube-hence the reason you have had 2 ectopic pregnancies.

Unblocking the tube surgically would unfortunately predispose you to an unacceptable risk of recurrent ectopic pregnancies.

The safest and most reasonable option would be to bypass the tube through IVF.

Sorry to hear about your previous history of ectopic pregnancies. This has some relevance since the conditions that lead to an increased risk for ectopic pregnancy are likely to affect both tubes in the pelvis, rather than just one side (since both tubes are connected to the uterus within the pelvis).

Some of these conditions include infection, inflammation due to endometriosis, or could be related to surgery.

Surgery to correct the blockage has been available for many years. This consists of microsurgery which can be performed through keyhole or laparoscopic surgery. In certain circumstances, we can even perform reversal of sterilisation by joining the tubes back together.

The question is, whether it is worth the effort, with the availability of IVF. With microsurgery, success will depend on the site and extent of the blockage. Even with physical relief of the blockage, functionality may still be affected - say for example, infection may have affected the inner lining of the tube that transports the egg or embryo. Surgical success at the end of surgery also may not guarantee that the tubes will not close up again, if the factors for the inflammation which caused it in the first place are still present.

Then there is the risk for ectopic pregnancy, since the transportation of the embryo may be impeded within the unblocked tube. Also, with surgery, there is downtime and costs to be considered.

So for the above reasons, IVF is a very good alternative, since it bypasses the fallopian tubes and places the fertilised embryo within the uterus.

However, you should evaluate for the presence of any hydrosalpinx (swollen Fallopian tubes) before IVF, since this can lower the success rates of IVF by up to 25-30%, probably due to the buildup of toxic chemicals in the tube. If there is hydrosalpinx, it is usually recommended to deal with it first before IVF. This can be either in the form of clipping the tube or removing the tube, and less likely correcting the blockage. Hope this helps.

Dr Fong Yoke Fai

Similar Questions

Am I able to combine TCM therapeutic treatments and western medicine to treat my infertility problem?

Thanks for the D2D. Yes, you're able to combine TCM therapeutic treatments and western medicine to treat my infertility problem. Many of my patients seek help from both Chinese and Western medicine to treat infertility. It is common for patients to take Chinese and western medicine concurrently. Many receive TCM treatments while undergoing IVF or IUI procedure. TCM and western medicine can work hand in hand to increase the chance of patient getting pregnant. Studies have also shown that acupuncture improves pregnancy rates in women undergoing IVF.

Photo of Human

Answered By


Is IVF or IUI the best treatment for infertility?

Thanks for the D2D. Both methods can be effective, but a lot depends on your medical condition and the causes of your subfertility in the first place. IUI is relatively simple, less invasive, less costly and less time-consuming, but the success rates are lower. Certain existing conditions make IUI less favourable, for example if your husband’s sperm count and quality are low, or if you have 1 or both fallopian tubes blocked. IVF gives you the best chance of getting pregnant, but it demands more of your time and effort, is more invasive and costly, and most ladies find it more stressful.

Photo of Human

Answered By


Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox