Removing the fallopian tubes—the curved ducts that connect the ovaries to the uterus to transport the egg—is now recommended in certain situations to reduce the risk of ovarian cancer.
In the past, if someone was having a hysterectomy (removal of the uterus) for reasons other than cancer (such as abnormal bleeding, pain, fibroids, prolapse, etc.), the fallopian tubes were typically left in place, along with the ovaries.
Similarly, during a tubal ligation for permanent birth control, the fallopian tubes were also left in place after cutting, tying or burning them to prevent future pregnancies.
Now, with ongoing research showing that removing the fallopian tubes can reduce the risk of ovarian cancer, more OB/GYNs are recommending removing them in situations like these–even for people at an average risk for ovarian cancer. In medical lingo, this is sometimes referred to as “opportunistic salpingectomy.”
Why you would remove your fallopian tubes
First, a quick anatomy lesson. The fallopian tubes are attached to the uppermost side of the uterus. They branch out on either side and sit on top of each ovary.
During childbearing years, their job is to catch an egg released during monthly ovulation and move it towards the uterus. In the case of fertilization, the tubes are where the sperm and egg fuse and form the cellular beginnings of a human embryo. This cluster of cells moves down the tube and, potentially, implants in the uterine lining for further cell division and growth.
How removing the fallopian tubes can reduce ovarian cancer risk
Recent recommendations from the spring of 2023 from the Ovarian Cancer Research Alliance (OCRA) and endorsed by the Society for Gynecologic Oncology, encourage people to have their fallopian tubes removed if they do not desire future fertility and are undergoing gynecologic surgery for other reasons anyway—such as a hysterectomy for abnormal bleeding, pain, fibroids or prolapse or a tubal ligation for permanent birth control.
Removing the fallopian tubes can reduce a person’s risk of developing ovarian cancer by 25 to 65%, according to various studies. While scientists and OB/GYNs don’t yet completely understand this connection, they have learned that many ovarian cancers—and maybe most of them—are actually cancers that start in the part of the fallopian tube nearest to the ovary.
It is also suspected that, at least in some cases, blood and tissue from inside the uterus can travel “backward” into the tubes and out into the pelvis and abdomen. Importantly, those cells from the uterine lining can also land on the ovary—and this might somehow be related to the later development of ovarian cancer.
How a salpingectomy is performed
The surgical approach for opportunistic salpingectomy–removal of the fallopian tubes as part of another pelvic or abdominal surgery–is dictated by the needs of the primary surgery, but is often performed laparoscopically. In laparoscopic surgery, small incisions are made through which the surgeon inserts instruments and a camera. The tubes are carefully cut and removed through the incisions or through the vagina.
Laparoscopic surgery is a minimally invasive procedure with a shorter recovery time compared to traditional surgery. Recovery times vary based on the extent of the overall surgery, but two to four weeks is typical.
For premenopausal patients who do not desire future fertility, the surgeon will most often remove the fallopian tubes while leaving the ovaries because the estrogen produced by the ovaries has other health benefits—and without it, menopausal symptoms will set in.
Long-term health implications of having your fallopian tubes removed
Long-term health implications of having your fallopian tubes removed depend on whether it was one or both, and if you kept your ovaries and/or uterus.
If you still have your ovaries and uterus, you’ll continue to have periods, and your hormone levels will not change as a result of the surgery.
Whether or not you can still get pregnant after a salpingectomy also depends on the extent of the surgery.
Removing one fallopian tube does not act as permanent contraception. Removing both tubes will prevent pregnancy without the help of in vitro fertilization-embryo transfer (assuming the uterus is still intact).
About one in 78 people will be diagnosed with ovarian cancer. The reduction of risk with fallopian tube removal is important because we don’t yet have an effective way to screen for the disease and the symptoms are often mistaken for other things, leading to later detection and fewer treatment options. If you’re planning a pelvic surgery, talk to your provider about the risks and benefits of fallopian tube removal.