Do you have a hydrosalpinx (a tube that is totally blocked at the end farthest away from the uterus) on one side or both sides? If only one side, you can get pregnant from the other tube, but having a hydrosalpinx lowers your chances.
If both sides are blocked you need IVF to conceive, but the chances of success with IVF are higher if you have surgery to disconnect or remove the hydrosalpinges first. For women undergoing IVF, having a hydrosalpinx on both sides reduces the IVF success rate by a third to a half. Fluid inside the blocked tube may be toxic to embryos, so the chances that embryos will implant inside your uterus are reduced – this lowers your success rate with IVF, with other fertility treatment like intrauterine inseminations (IUI), or with ‘trying on your own’. One-sided hydrosalpinx may have less effect. Removing the hydrosalpinx or disconnecting it from the uterus improves your fertility. Traditionally this is done with outpatient laparoscopic surgery; we have less-invasive hysteroscopic options as well such as Adiana or Essure to block off the tube where it joins the uterus.
A hydrosalpinx does not stop your ovaries from producing eggs or releasing eggs (though it of course stops the egg and the sperm from getting together inside the blocked tube). Having said that, the disease that blocked your tubes may have damaged your ovaries and caused low egg supply (diminished ovarian reserve). Pelvic infections like chlamydia or Pelvic Inflammatory Disease (PID) are the most common causes of hydrosalpinx, less commonly endometriosis, previous surgery, or ruptured appendix. Low egg supply reduces your chances of conceiving no matter what your age is.
Most women with hydrosalpinx do not need to use a gestational carrier – as long as you’re willing to have the hydrosalpinges treated with surgery. Reasons to use a gestational carrier are diseases of the uterus that are not fixable with surgery (like severe scar tissue after fibroid removal), removal of the uterus (hysterectomy), medical conditions making pregnancy unsafe for you, and rarely for repeated implantation failure with IVF embryos.
With a hydrosalpinx I recommend seeing a Fertility specialist MD (Reproductive Endocrinology / Infertility or REI MD), who can do tests including checking you for diminished ovarian reserve, and then come up with an individualized treatment plan to help you get pregnant.