Fallopian Tubes Problems

Common Fertility Problems
 
Key Points

  • Tubal factor infertility is responsible for 25-30% of all infertility cases.
  • It can prevent the egg and sperm to meet, or the fertilised egg to move to the uterus for implantation.
  • Treatment depends on the cause of tubal problem.

What Are Fallopian Tubes?

Fallopian tubes are female reproductive organs that connect the ovaries and the uterus. This is where the egg and sperm meet and fertilisation occurs. Tubal factor infertility occurs when there is a blockage or damage in the fallopian tubes that doesn’t allow the egg and sperm to meet. It accounts for 25-30% of all cases of infertility.

Causes of Tubal Factor Infertility

Fallopian tube problems result from conditions that block or damage the tube:

  • Pelvic infections (such as pelvic inflammatory disease) which cause scarring or hydrosalpinx.
  • Endometriosis. Endometrial tissue can develop in the fallopian tubes and cause a blockage. Endometrial tissue on the outside of other organs can also cause adhesions that block the fallopian tubes.
  • Sexually transmitted infections (STIs). Chlamydia and gonorrhea can cause scarring and lead to pelvic inflammatory disease.
  • Past ectopic pregnancy. This can scar the fallopian tubes.
  • Fibroids are growths that can block the fallopian tube.
  • Past abdominal or pelvic surgery, especially on the fallopian tubes themselves, can lead to pelvic adhesions that block the tubes.
  • Birth defects of the uterus or fallopian tubes.

Diagnosis of Tubal Factor Infertility

Hysterosalpingography
Commonly used to check for problems with the fallopian tubes. Contrast agent is injected in the cervix and X-rays are taken after. The contrast agent outlines the interior of the uterus and fallopian tubes. It can detect some structural disorders that can block the fallopian tubes. However, in about 15% of cases, hysterosalpingography indicates that the fallopian tubes are blocked when they are not—called a false-positive result. After hysterosalpingography, fertility in young women appears to be slightly improved even if the results are normal, possibly because the procedure temporarily widens (dilates) the tubes or clears the tubes of mucus

Laparoscopy
It’s surgery and requires general anaesthetic.It consists in the insertion of a small camera in the pelvic cavity through a small incision just below the navel. It provides an overview of the outside of the uterus, fallopian tubes and ovaries.

Sonohysterography
Sometimes used to detect and/or to further evaluate problems with the fallopian tubes and other abnormalities in the pelvis. A salt (saline) solution is injected into the interior of the uterus through the cervix during ultrasonography so that the interior is distended and abnormalities can be seen more easily. If the solution flows into the fallopian tubes, the tubes are not blocked.


Hysteroscopy
If an abnormality within the uterus is detected, doctors examine the uterus with a camera called a hysteroscope, which is inserted through the vagina and cervix into the uterus. If adhesions, a polyp, or a small fibroid is detected, instruments inserted through the hysteroscope may be used to dislodge or remove the abnormal tissue, increasing the chances that the woman will become pregnant.

Treatment of Tubal Factor Infertility

Treatment depends on the cause of obstruction

  • Laparoscopy or hysteroscopy to remove abnormal tissue
  • Surgery to remove polyps or fibroids
  • Antibiotics for infections
  • In vitro fertilization

The Small Book of Fertility Hormones

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