{"id":22565,"date":"2025-04-28T10:26:25","date_gmt":"2025-04-28T15:26:25","guid":{"rendered":"https:\/\/naturalwomanhood.org\/?p=22565"},"modified":"2025-05-28T09:44:13","modified_gmt":"2025-05-28T14:44:13","slug":"%d1%81%d0%b0%d0%bb%d1%8c%d0%bf%d0%b8%d0%bd%d0%b3%d1%8d%d0%ba%d1%82%d0%be%d0%bc%d0%b8%d1%8f","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/ru\/salpingectomy\/","title":{"rendered":"\u041d\u0443\u0436\u043d\u0430 \u043b\u0438 \u0432\u0430\u043c \u0441\u0430\u043b\u044c\u043f\u0438\u043d\u0433\u044d\u043a\u0442\u043e\u043c\u0438\u044f?"},"content":{"rendered":"\n

While the fallopian tubes are crucial for female fertility, as we covered at length in our fallopian tubes primer,<\/a> there are some cases when surgical removal of the tubes may be recommended. Sometimes, conditions can be treated by a salpingostomy, or a small incision into the fallopian tubes. Other times, complete surgical removal of the fallopian tube\u2014or salpingectomy\u2014is needed. Here we also briefly cover the most common fallopian tube surgery, a permanent female sterilization procedure called tubal ligation. <\/p>\n\n\n\n

Salpingectomy to reduce ovarian cancer risk<\/span><\/h2>\n\n\n\n

Women who have a BRCA1 or BRCA2 mutation may be counseled by their healthcare professional to have their fallopian tubes and ovaries removed. These are genetic mutations that are known to increase your risk of breast, ovarian, and fallopian tube cancers. But how would you know if you have one or both of these mutations? If you have a close relative with breast cancer or personal history of breast cancer, you may be offered genetic testing for BRCA1\/2 mutations.<\/p>\n\n\n\n

If you have a BRCA1 or BRCA2 mutation and<\/em>\u00a0one additional genetic mutation, your doctor may recommended a salpingectomy (removal of both tubes) \u00a0to reduce the risk of ovarian cancer [1]. However, this is a permanently sterilizing<\/em> procedure, with no guarantee<\/em> that it will prevent ovarian cancer (including ovarian cancer due to other causes). The risk of developing ovarian cancer by age 70 if you have BRCA1 is 40-60% (another research study puts the estimates lower, at 39%-46% risk) and 11-27% if you have BRCA2 [1][2].<\/p>\n\n\n\n

Should you also have an oophorectomy to reduce ovarian cancer risk if you have BRCA 1 or BRCA2?<\/span><\/h3>\n\n\n\n

Historically, women determined to be at high risk of hereditary breast and ovarian cancer (HBOC) were recommended to undergo preventative removal of both ovaries\u00a0and<\/em>\u00a0both fallopian tubes either a) when the woman had finished childbearing, b) by age 35-40, or c) 10 years before the age of diagnosis of a close relative diagnosed with ovarian cancer. But reality has not matched recommendations, as \u201cit is believed that the majority of these high-risk women do not undergo (risk-reducing salpingo-oophorectomy) by age 40\u201d [1]. This is in part because removal of the ovaries puts young women into surgically-induced menopause, with attendant risks of cardiovascular problems, impaired sexual function, osteoporosis, cognitive impairment, and higher likelihood of death in general.\u00a0<\/p>\n\n\n\n

Fortunately, recent research has allowed the National Comprehensive Cancer Network to more narrowly target its recommendations. Epithelial ovarian cancer is the most common type of ovarian cancer. Researchers now have evidence that the most common and aggressive subtype of epithelial ovarian cancer, high-grade serous carcinoma (as well as, to a lesser extent, epithelial ovarian cancer subtype low-grade serous carcinoma), actually develops in the\u00a0fallopian tube<\/em>\u00a0epithelium [1]. Thus, young women with known BRCA mutations may choose to have only their fallopian tubes removed after childbearing is complete, with the potential to remove the ovaries at a later date. The major benefit of this approach is that the young woman does not go into early menopause, but without either fallopian tube she is still rendered permanently infertile without guarantee that she won’t develop breast or ovarian cancer (including cancers due to other reasons) [1].\u00a0<\/p>\n\n\n\n

Researchers note that removal of the fallopian tubes alone should also reduce risk of epithelial ovarian cancer subtypes clear cell and endometriosis-related ovarian cancer, in addition to the high-grade serous carcinoma and low-grade serous carcinoma subtypes [1]. <\/p>\n\n\n\n

Are there ethical concerns with salpingectomy and\/or oopherectomy to prevent ovarian cancer?<\/span><\/h3>\n\n\n\n

Many of our Natural Womanhood readers come from a Judeo-Christian background and may wonder whether it’s morally permissible to have their tubes removed (with resultant sterilization) with the hope of preventing ovarian and\/or breast cancer. <\/p>\n\n\n\n

We offer a 2019 statement <\/a>from the National Catholic Bioethics Center for their consideration: “Given the radical and irreversible loss of fertility resulting from this intervention, we believe that it is necessary, generally speaking, that there be evidence of heightened risk (not just average risk) of cancer for the individual woman who is considering this procedure. This heightened risk could be ascertained, for example, through direct diagnosis, genetic testing, or family history risk-assessment (e.g., blood relatives diagnosed with the same kind of cancer), or other means.” <\/p>\n\n\n\n

Salpingectomy to treat tubal ectopic pregnancy <\/span><\/h2>\n\n\n\n

In the case of a tubal ectopic pregnancy (the most common type of ectopic pregnancy<\/a>), surgical removal<\/a> of the entire fallopian tube is sometimes required. This depends on the location of the embryo and\/or extent of damage to the fallopian tube [3]. Other times, a salpingostomy (an incision in the tube) can remove the ectopic pregnancy and<\/em> preserve the fallopian tube for future fertility.<\/p>\n\n\n\n

Finally, when a fallopian tube is filled with too much fluid or is severely infected, surgical removal may also be necessary for complete treatment. <\/p>\n\n\n\n

How does salpingectomy affect fertility?<\/span><\/h2>\n\n\n\n

While removing the fallopian tubes typically has minimal or no effect on female hormone levels (unlike removing the ovaries), removing one\u00a0can<\/em>\u00a0result in reduced fertility (or infertility if both tubes are removed). It\u2019s important to discuss fertility goals, cancer risk, and overall health with a doctor if you\u2019re considering fallopian tube removal.<\/p>\n\n\n\n

Tubal ligation<\/span><\/h2>\n\n\n\n

Tubal ligation is a form of permanent contraception, also called female sterilization. It is typically performed laparoscopically, or through an abdominal incision. While a salpingectomy refers to removal<\/em> of the fallopian tubes, tubal ligation may refer to cutting, tying, clipping cauterizing, or completely removing the tubes. <\/p>\n\n\n\n

Tubal ligation is not without side effects, some of which (like post-tubal ligation syndrome<\/a>) can be quite severe, and include painful periods, PMS- and menopause-like symptoms, migraines, and risk of a (non-tubal) ectopic pregnancy (should fertilization still occur, and research suggests<\/a> that this rare occurrence may happen more often than previously believed!). <\/p>\n\n\n\n

For women who seek effective pregnancy prevention options without the side effects of tubal ligations, fertility awareness methods<\/a> and can be an empowering option for couples seeking to avoid pregnancy indefinitely or permanently. And for women or couples who change their minds about their family size being complete, tubal ligation reversal surgery<\/a> has relatively high success rates. <\/p>\n\n\n\n

The bottom line <\/span><\/h2>\n\n\n\n

Salpingectomy, the removal of your fallopian tubes, may be recommended to treat an ectopic pregnancy or to reduce ovarian cancer risk in premenopausal women with a certain genetic mutation and a family history of breast and\/or ovarian cancer. Tubal ligation, a female sterilization procedure intended to be permanent, may prevent conception through manipulation of the fallopian tubes or their removal altogether, but it is not without the potential for side effects <\/a>and, for some, regret. However, there are alternatives to sterilization that allow both men and women to keep their reproductive systems intact (and you can read about them here<\/a>).<\/p>\n\n\n\n

This article was edited on May 23, 2025, to include the statement from the National Catholic Bioethics Center on whether it’s morally permissible to undergo a salpingectomy with the goal of preventing ovarian and\/or breast cancer. <\/em><\/p>\n\n\n\n

References:<\/p>\n\n\n\n[1] George SH, Garcia R, Slomovitz BM. Ovarian Cancer: The Fallopian Tube as the Site of Origin and Opportunities for Prevention. Front Oncol. 2016 May 2;6:108. doi: 10.3389\/fonc.2016.00108. PMID: 27200296; PMCID: PMC4852190.<\/p>\n\n\n\n[2] Holman LL, Friedman S, Daniels MS, et al. Acceptability of prophylactic salpingectomy with delayed oophorectomy as risk-reducing surgery among BRCA mutation carriers. Gynecol Oncol. 2014 May;133(2):283-6. doi: 10.1016\/j.ygyno.2014.02.030. Epub 2014 Feb 28. PMID: 24582866; PMCID: PMC4035022.<\/p>\n\n\n\n[3] Yeung, P., Mohan, A., & Gavard, J. \u201cThe Long-term Rate of Repeat Surgery After Optimal Excision Surgery of Endometriosis at a Single Tertiary Referral Center.\u201d Preprints.(2024) https:\/\/doi.org\/10.20944\/preprints202409.1485.v1<\/a>. *Pre-print study that has not yet been peer reviewed.<\/p>\n\n\n\n

<\/p>\n\n\n\n

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