Jessica Simpson gets candid about a lot in her new memoir Open Book, including the sexual abuse she suffered as a child, overcoming an addiction to alcohol, her romantic relationships, and her struggles with body image. The book is one of the rare celebrity memoirs that allows the reader to empathise deeply with the star. In addition to relating to Simpson's stories of bad boyfriends and struggles with self-esteem, I found I had I another connection to the singer, actress, and mogul – we both had a fallopian tube removed, and we both later went on to have healthy pregnancies.
In her book, Simpson writes about visiting a doctor after experiencing pain and cramping while on a gruelling tour early in her career. She was initially misdiagnosed as having an enlarged bladder, was treated and sent home with only aspirin. But at a showcase in Boston, the pain returned — and worsened. An OB/GYN performed an ultrasound, found a cyst on her right fallopian tube, and performed laparoscopic surgery to have the tube — by now too damaged to be repaired — taken out.
"I want to have babies," Simpson describes telling her doctor. "Please don't take them away from me." He responds that the surgery "would mean from then on I could likely only get pregnant every other month." Simpson, though, went on to have three children.
The doctor's comment piqued my interest. I had a fallopian torsion — meaning my tube had twisted and become gangrenous — when I was 9 years old. I was misdiagnosed and by the time the torsion was detected, the tube was so damaged that it had to be removed. As I began to think about having children, I worried that having one tube would make conception difficult. But my doctors always assured me that, while this could have an effect, it certainly didn't halve my chances of getting pregnant, as Simpson's doctor implied.
I spoke with Lucky Sekhon, MD, a reproductive endocrinologist, infertility specialist, and board certified obstetrician and gynecologist to get some clarity. Who was right: my doctor or Simpson's?
Dr. Sekhon explained that the singer had gotten some incorrect info. People don't ovulate from one ovary one month and the other the next month, as Simpson's doctor seemed to suggest.
What's more, Dr. Sekhon added in an email: "Because of gravity, the fallopian tubes and ovaries actually sit right next to each other, often behind the uterus. Therefore, it is possible for an egg from one ovary to ‘skip’ over to the other side and enter the opposite fallopian tube." So even if I ovulate from my left ovary (the side where I have no fallopian tube), that egg could find its way to my right tube and result in a pregnancy.
In addition to cysts and torsions, the fallopian tubes can be damaged by infections (such as gonorrhea and chlamydia) and ectopic pregnancy, Dr. Sekhon said. The latter occurs when a fertilized egg gets stuck in a tube on its way to the uterus.
"The implanted pregnancy leads to permanent damage and scarring of the tube," she said. "If an ectopic pregnancy progresses too far, the tube can rupture, which can lead to life-threatening bleeding where emergency surgery to remove the bleeding tube is performed."
I also spoke with 39-year-old, Elizabeth, who'd had an ectopic pregnancy when she was 27 that resulted in the loss of of a tube — and nearly her life. Today she has two children. Once again, an early misdiagnosis was one of the reasons the tube eventually had to be removed.
"I didn't even realise I was having a miscarriage," Elizabeth related. "My period was late and when it started there was unusual clotting and pain. It was a coworker who actually suggested I go to the doctor. I was reluctant to go because I didn't have health insurance, but eventually the pain got worse. I found out at the doctor that I was miscarrying. Because I was paying out of pocket, she didn't perform an ultrasound, saying it would save me money."
But an ultrasound would have revealed that there was no sac in her uterus and likely tipped the doctors off to the ectopic pregnancy. Instead, Elizabeth went on to have a scheduled D&C. During the surgery, the tube where her embryo had implanted ruptured. Her left tube was removed, and doctors told her that her fertility might be compromised. But because her ovary was still intact (as was mine, and Simpson's) they couldn't say how difficult (or not) it might be to conceive. Nine months later, Elizabeth became pregnant with her first child, and two years later she had a second.
The bottom line, says Dr. Sekhon, is that getting pregnant is already kind of tough. "There's only a 15% change of conceiving from any given ovulation," she says. So, while having a single Fallopian tube can add a slight complication to conceiving naturally, as long as the remaining tube and and ovaries are healthy, there's no evidence that your chances of getting pregnant will be cut in half.
Simpson's experience — and Elizabeth's, and mine — highlight the need for women to advocate for themselves in medical situations. Early intervention would have likely preserved all of our fallopian tubes. Our stories also call attention to the importance of making affordable access to quality healthcare a reality for everyone. Nobody should have to make a difficult choice to forego a potentially lifesaving procedure due to cost alone.