It’s a fertility treatment for patients when the ends of their Fallopian tubes are missing or blocked.

For women who have undergone the surgical removal of their fimbria (e.g. during a cut and tie sterilisation or partial removal of the tube for an ectopic pregnancy), an important part of the fallopian tube needed to achieve a pregnancy, is missing. The fimbria is responsible for capturing eggs during ovulation, so when removed the prospects of conceiving naturally may appear bleak.

This is equally the case for women who have never had surgery but whose fimbria are found to be damaged or sealed up (often diagnosed when undergoing tubal blockage testing (e.g. HyCoSy/ HSG) as part of a routine fertility work up). Non-surgical causes can include a previous pelvic infection or a condition such as endometriosis.

Fortunately, Medical advancements offer alternative approaches, such as ampullary salpingostomy, to help these individuals achieve a pregnancy without the need for IVF.

In this blog, we will review what ampullary salpingostomy is and discuss its potential as a fertility treatment for patients with absent or damaged fimbrial ends.

What is an Ampullary Salpingostomy?

An Ampullary salpingostomy is a surgical procedure to create a new or enlarge an existing tubal opening at the ends of the fallopian tubes, in a portion of the tube called the ampulla, situated near the ovary. By creating a new opening the aim is to restore the ability of the tubes to capture the egg during ovulation.

What does the Procedure involve?

The surgical procedure itself is performed under general anaesthetic either open (via a small cut on your tummy) or by keyhole surgery. The surgeon carefully identifies the ampulla of the fallopian tube and creates a small incision or enlarges an existing one to form a new opening. The surgeon, using microsurgical techniques, then places several tiny sutures around the opening of this hole to create a new fimbrial opening. This allows the eggs released from the ovary to enter the fallopian tube so that natural conception may occur.

Benefits and Considerations:

  • Potential for natural conception restored: Ampullary salpingostomy offers hope to women with blocked or absent fimbria, allowing them to improve their chances of conceiving naturally. By creating a new opening, an egg can now enter the tube to meet the sperm.
  • Reduce or avoid the need for IVF treatments: While assisted reproductive techniques, such as in vitro fertilization (IVF), can be very successful, they are costly and emotionally challenging. Ampullary salpingostomy offers an opportunity to conceive without the need for IVF, making it a favourable option for those seeking a less costly and challenging path to pregnancy.
  • Considerations: It is important to remember that not everyone is suitable for an ampullary salpingostomy. It is important to speak to a qualified fertility specialist to determine the most appropriate treatment option for you. Factors that affect suitability include:
    • The overall health of the fallopian tubes
    • The presence of other causes of subfertility
    • The age of the patient

Finally, having damaged or absent fimbria can leave many women feeling like their only option is to have IVF treatment. Ampullary salpingostomy however, by restoring the ability of the tubes to captures eggs, offers hope for these women wanting to become pregnant more naturally.

If you would like more information or would like to discuss your fertility options with an experienced sub-specialist accredited fertility surgeon, please contact Mr Dobson’s P.A, Mandy Banbury, or phone 0115 966 2111 to arrange a face to face or telephone appointment.