DAMAGE TO FALLOPIAN TUBES
Every month when ovulation occurs, one of the ovaries releases an egg. The egg will travel from the ovary through the fallopian tubes into the uterus. The sperm will also need to find its way from the cervix through the uterus and the fallopian tubes to get to the egg. Fertilization normally occurs when the egg is traveling through the fallopian tube.
WHAT ARE FALLOPIAN TUBES?
They are two thin tubes on each side of the uterus. They help to lead the mature egg from the ovaries to the uterus.
When there is an obstruction, it prevents the egg from traveling down the tube. In this case, the woman has a blocked fallopian tube. Also known as tubal factor infertility and is the cause of infertility in 40% of infertile women. This condition can occur on one or both sides.
SYMPTOMS OF BLOCKED FALLOPIAN TUBES
Women may experience certain symptoms or nothing at all. If symptoms are present, they may include:
- Strong to mild abdominal pain
- Painful periods
- Strange looking or smelling vaginal discharge
- Feeling pain while having sex or passing urine
Blocked fallopian tubes can go unnoticed as many women still ovulate even though they have the condition. It’s only until a woman is trying to get pregnant, this condition becomes noticed.
TREATMENT OPTIONS FOR BLOCKED FALLOPIAN TUBES
Each year, thousands of women are diagnosed with blocked fallopian tube. The number one question on their minds is “how can I reopen them?”
There are many options for healing the fallopian tubes and in many cases they can be re-opened once again. It is important to note that the fallopian tubes are almost as thin as the size of a spaghetti noodle in width.
It may be difficult to reverse the damage once they’ve been damaged. Any sort of trauma can change their function and damage the tubal tissues. A variety of medical options for reopening the fallopian tubes are as follows:
Tubal surgical procedures can either be done by open abdominal surgery or laparoscopy (small incision).
- Salpingectomy: Part of the fallopian tube is removed. Commonly performed for hydrosalpinx prior to IVF treatment. According toFertility and Sterility, leaving hydrosalpinx untreated will make IVF half as likely to be successful.
- Salpingostomy: Performed when the end of the fallopian tube is blocked by hydrosalpinx. A new opening is made in the fallopian tube entrance nearest to the ovary. Most of the time, the success of this procedure is temporary and often scar tissue reforms causing another blockage within 3-6 months.
- Fimbrioplasty: An option for women with damage to the fimbriae. This procedure may be recommended if the fimbriae and its cilia are stuck together by scar tissue, which is preventing the ova from being picked up. This procedure works to rebuild the fimbriae. Medical insurance often does not cover the cost of this procedure and very few doctors are experts in this type of procedure. Fimbrioplasty is now recommended for select cases over salpingostomy, which has been shown to be less successful.
The procedures above have about 20-30% of pregnancy success rate.
- Selective tubal cannulation: Performed for proximal tubal occlusion (where the tube meets the uterus). Hysteroscopy or fluoroscopy is used for guidance as your doctor insert a catheter through your cervix, uterus and into the fallopian tube. This is a non-surgical procedure that has a 60% pregnancy success rate.
- Tubal ligation removal: Also known as tubal reanastomosis. This is a surgical procedure that is performed with the assistance of a microscope and is generally done in a hospital setting or outpatient surgical facility. The portion of the fallopian tube that was tied or cauterized will be removed in the original surgery and the two ends will be reattached to make a complete tube. This procedure has a 75% pregnancy success rate.
Your surgeon may clip away adhesions from the fallopian tubes, ovaries and uterus so the reproductive organs can move freely once again during the surgery.
DIAGNOSING BLOCKED FALOPIAN TUBES
- STI testing: STIs found during routine tests (pap smear) is usually a sign to check for possible fallopian tube damage.
- Routine ultrsound: Sometimes when checking for something else during an ultrasound, it may reveal fallopian tube blockages. A fallopian tube is not visible in an ultrasound but it will be able to be seen if it is inflamed due to hydrosalpinx fluid.
- Hysterosalpingogram:This is a special kind of x-ray used to evaluate female fertility and is used to diagnose blocked tubes. A dye is placed through the cervix using a tiny tube. Once the dye has been given, the doctor will take x-rays of your pelvic area. If all is normal, the dye will go through the uterus, through the tubes, and spill out around the ovaries and into the pelvic cavity.If the dye doesn’t reach the tubes then you may have a blocked fallopian tube. It’s important to note that 15% of women have a “false positive,” where the dye doesn’t reach the tubes.
Your doctor may repeat the test another time if this happens or order a different test to confirm if the blockage appears to be right where the fallopian tube and uterus meet. Other tests include ultrasound, exploratory laparoscopic surgery or hysteroscopy (where a thin camera is placed through your cervix to look at your uterus).
Blood work may be ordered to check for the presence of Chlamydia antibodies (to imply previous or current infection) may also be ordered.
- Hysterosalpingography:This procedure is similar to hysterosalpingogram. A special contrast medium is injected into the uterus which will then pass through the fallopian tubes and spill around the ovaries and into the pelvis. The procedure is observed on real-time ultrasound.
- Pelvis surgery (usually by laparoscopy keyhole surgery): Coloured dye can be injected into the uterus and can be seen directly.