Tubal Problems

What is tubal factor infertility?
Infertility of the tubal factor occurs when a blockage within the fallopian tubes doesn’t allow the egg and sperm to satisfy. Infertility of the tubal factor represents approximately 25-30% of all cases of infertility. The condition includes cases of completely blocked fallopian tubes and cases during which just one may be a blocked tube or narrowing of the tubes.

What causes tubal factor infertility?
Infections, abdominal surgery and diseases like endometriosis can cause scars between the top of the Fallopian tube and therefore the ovary. Infections are often, but not necessarily, sexually transmitted. Chlamydia and gonorrhea are two common sexually transmitted infections that will cause tubal infertility. Tuberculosis, uncommon in North America, and a broken appendix can cause a tubal infection. Surgery also can damage your fallopian tubes.

Pelvic disease (PID) also can travel from the cervix through the uterus to the tubes, which may eventually cause the fragile inner lining of the tubes to heal permanently. The opening of the tube next to the ovary is often partially or completely blocked; connective tissue will often form on the surface of the tubes and uterus.

What are the symptoms of tubal factor infertility?
Most women with tubal infertility are asymptomatic. They often don’t realize that their fallopian tubes are blocked until they see a doctor for infertility, although women with extensive tubal damage may experience chronic pelvic pain.

How is tubal factor infertility diagnosed?
To confirm whether one or both fallopian tubes are blocked or not, your doctor can perform one among these two procedures:

Hysterosalpingography (HSG): Infertility of the tubal factor is typically investigated first with an HSG, which is an X-ray examination by a radiologist. A speculum is employed to open the vagina, then a catheter is inserted to inject fluid through the cervix (the opening to the uterus) into the uterus. If liquid comes out of the ends of 1 or both tubes, you’ll determine if one or both tubes are open. If the liquid doesn’t enter or flow completely through one or both tubes, then the affected tube is taken into account blocked. it’s important to understand that if the test finds that the fallopian tubes are open, it doesn’t mean that the tubal function is normal. The inner lining of the Fallopian tube can suffer serious damage albeit the liquid flows through the tube within the HSG. additionally, this test may falsely suggest that the tubes are blocked if a blockage appears within the area where the tubes are inserted into the uterus (false positive). This false-positive finding can occur in 15% of girls.
Laparoscopy: During this minimally invasive outpatient procedure, a medical instrument called a laparoscope is inserted through a really small incision under the belly button. The surgeon can look around the laparoscope to ascertain if one or both tubes are open. The laparoscope also can be wont to search for other problems that will affect fertility, like connective tissue (adhesions) or endometriosis.
How is tubal factor infertility treated?
In vitro fertilization (IVF): Although some tubal problems are correctable with surgery, women with severely damaged tubes have so little chance of achieving a natural pregnancy that IVF offers them the simplest option for a successful pregnancy. Because very damaged tubes may fill with fluid (hydrosalpinx) and reduce IVF success rates, your doctor may recommend the removal of damaged tubes before IVF.
Surgery: If your tubes aren’t badly damaged, surgery may assist you to get pregnant naturally. Your chance of conceiving after surgery is best if you’re young, have a minimal amount of connective tissue that blocks the tubes and if your partner has healthy sperm. the best risk after tubal surgery is that the possible development of an ectopic (tubal) pregnancy. An extrauterine pregnancy may be serious ill health that’s more likely to occur after surgery or tubal disease. If you underwent tubal surgery or tubal disease, you ought to inform your doctor as soon as you think that you’re pregnant or your period has passed.

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