Female infertility of tubal origin
What is it?
Tubal factor infertility occurs when a blockage in the fallopian tubes will not allow the egg and sperm to meet. Tubal factor infertility accounts for about 25-30% of all cases of infertility. The condition includes cases of completely blocked fallopian tubes and cases where just one is blocked tube or scarring narrows the tubes.
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Female infertility of tubal origin.
Signs & symptoms
Most women with tubal infertility are asymptomatic. Often they don’t realize their fallopian tubes are blocked until they consult a doctor for infertility, though women with extensive tubal damage may experience chronic pelvic pain.
Diagnosis
To confirm whether or not one or both fallopian tubes are blocked, your doctor may perform one of these two procedures:
* Hysterosalpingogram (HSG)- Tubal factor infertility is usually investigated first with an HSG which is an X-ray examination performed by a radiologist. A speculum is used to open the vagina, then a catheter is inserted to inject liquid through your cervix (the opening into the uterus) into the uterus. If liquid comes out the ends of one or both of your tubes, then you can determine if one or both tubes are open. If the liquid does not enter or flow completely through one or both of your tubes, then the affected tube is considered blocked. It’s important to realize that if the test finds the fallopian tubes open, it does not mean that tubal function is normal. The inside lining of the fallopian tube may be severely damaged even though the liquid flows through the tube on the HSG. In addition, this test may falsely suggest that the tubes are blocked if blockage appears in the area where the tubes insert into the uterus (false positive). This false positive finding can occur in 15% of women.
* Laparoscopy- In this minimally-invasive outpatient procedure, a surgical instrument called a laparoscope is inserted through a very small incision below your belly button. The surgeon can look through the laparoscope to see if one or both of your tubes are open. The laparoscope can also be used to look for other problems that may affect fertility, such as scar tissue (adhesions) or endometriosis.
Treatment
If your tubes are found to be blocked, scarred, or damaged, your treatment options include in vitro fertilization (IVF) or surgery.
* In vitro fertilization (IVF)- Although some tubal problems are correctable with surgery, women with severely damaged tubes have such poor chances of achieving pregnancy naturally that IVF offers them the best option for a successful pregnancy. Because very badly damaged tubes may fill with fluid (hydrosalpinx) and lower IVF success rates, your physician may recommend removal of damaged tubes prior to IVF.
* Surgery- If your tubes are not badly damaged, surgery might help you get pregnant naturally. Your chance of conceiving after surgery is better if you are young, having minimal amount of scar tissue blocking the tubes, and if your male partner has healthy sperm. The biggest risk after tubal surgery is the possible development of an ectopic (tubal) pregnancy. An ectopic pregnancy is a serious health problem that is more likely to occur after tubal surgery or tubal disease. If you have had tubal surgery or tubal disease, you should tell your doctor as soon as you think you are pregnant or have missed your period
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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