Author Name: Dr. Ruchita Sharma Mentor Name: Dr. Sutapan Samanta on April 07, 2020
Fallopian tube and fertility
Fallopian tubes are part of female reproductive organs that connect the ovaries to the uterus. It is paired structure that lies at the upper part of womb and plays important role in reproductive potential of women.
Role of fallopian tube:
Every month in majority women ovulation occurred at middle of their menstrual cycle , when ovum released from ovary collected by the end of fallopian tube and if fertilized is carried to womb.
Fallopian tube has fluid rich in mucoprotiens, electrolytes and enzymes, secreted during time of ovulation, which help in fertilization and nourishment and early development of embryo.
Fallopian tube have multiple hair-like filaments and synchonised sweeping movements of these ciliary filaments help in transport of ovum from the fimbrial end ( part of tube that helps in collecting ovum from ovary ) towards ampulla ( part of tube where fertilization takes place ) and subsequently movement of fertilized ovum towards uterus.
Background of tubal factor infertility :
Tubal factor of infertility accounts for 25-30% of cause of infertility. Women usually does not aware of tubal patency until tested for fertility evaluation as blocked tube mostly does not cause any symptoms, occasionally there may be mild pain, one side of lower abdomen . only In case of disease like endometriosis, it may cause severe pain during menstruation.
If there is only one tube gets affected there may be chance of natural pregnancy, fertility drugs may help you to conceive.
If fallopian tube is partially blocked, then chance of ectopic pregnancy increased due to improper ciliary movement and fertilized ovum can not travel towards uterine cavity.
If both fallopian tubes gets blocked on both sides, the passage of sperm to ovum is blocked , hence fertilization does not take place. In this case natural pregnancy is not possible, and it is advisable to go for IVF treatment.
CAUSES OF TUBAL BLOCKAGE:
Pelvic inflammatory disease: This disease can cause scarring or hydrosalpinx ( abnormal fluid accumulation within fallopian tubes ) , The incidence of tubal infertility accounts for 8%, 20%, 40% after 1,2, and 3rd episodes of PID respectively. Genital tuberculosis is also important cause in indian scenario.
Endometriosis: This disease can cause adhesions in lower abdomen and pelvic area and distort anatomy of the fallopian tubes .
Sexually transmitted infections (STIs): Chlamydia and gonorrhea can cause scarring of fallopian tubes and lead to pelvic inflammatory disease and infertility.
History of Past ectopic pregnancy – partially or totally removed diseased tubes can cause infertility.
Past abdominal surgery: Past surgery, especially on the fallopian tubes can lead to pelvic adhesions that can block the tubes.
METHODS FOR TUBAL INVESTIGATIONS:
For tubal patency evaluation , available tests are-
Hysterosalpingography / HSG – a radiopaque dye inserted from the cervix, to the uterus , and images taken by xray. Course and patency of the tube can be assessed.
Laparoscopy Dye test: direct visualization of both tubes and surrounding pathology is done by putting telescope inside abdomen , Presence of any hydrosalpinx or tubal saccluations, adhesions surrounding tubes , fimbrial cyst, paraovarian cyst and any uterine, ovarian or tubal pathologies can be identified as part of infetility investigation.
TREATMENT OF BLOCKED TUBES:
If there is blockage due to adhesions , as in case of moderate and severe endometriosis, adhesiolysis can be done .
Hysteroscopic proximal tubal canulation can also be tried in case of proximal tubal block.
Following tubal ligation surgery , one can opt for tubal sterilization reversal , however success is limited and chance of ectopic pregnancy ( a lifethreating condition )increased. Hence IVF is definitely better option in such case.
Also following hydrosalpinx , tubal cilia gets damaged , so it renders the tubes non functional in most cases and IVF following removal of damaged tubes or tubal clipping will enhance its success.
SURGERY vs IVF – CONCLUSION :
Natural conception after surgery for fallopian tubes which is damaged by an infection or ectopic pregnancy is not so common. Further it can increases the chances of ectopic pregnancy, which can endanger life of a woman.
Although Blocked fallopian tubes cause infertility in women, but it’s still possible to have a baby . IVF is the best possible option and worlds first test tube baby was born because of infertility due to blocked fallopian tubes.
We at INDIRA IVF offer this miracle of science to fulfill your family in most empathetic way.
Talk to the best team of fertility experts in the country today for all your pregnancy and fertility-related queries.
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