“Tubal factor infertility is present in about a quarter of infertility cases. Tubal damage can include scar tissue within the fallopian tubes or completely blocked fallopian tubes as a result of birth defect, surgery or injury from an ectopic pregnancy. Tubal damage can also be caused by pelvic inflammatory disease (PID) or pelvic endometriosis.” Mark Rispler, M.D.
Correcting Tubal Abnormalities to Facilitate a Pregnancy
Fallopian tubes provide a concourse where ovulated egg and sperm converge, and a pathway for a
fertilized egg to travel before reaching the uterus for implantation. This anatomical superhighway is essential to the reproductive process. Of all the female causes of infertility, tubal abnormalities are the most common, and one of the most complex to correct.
Dr. Mark Rispler explains the options available to overcome infertility caused by damaged or blocked fallopian tubes.
Investigating blocked or damaged Fallopian tubes
Causes of tubal abnormalities
• History of sexually transmitted disease
• History of endometriosis
• Pelvic infection or pelvic inflammatory disease
• Abdominal or pelvic surgery
• Congenital defects
• Tubal ligation
A fertility test called a hysterosalpingogram (HSG) will indicate whether the fallopian tubes (salpingitis) are blocked, particularly if the area affected is at the corneal segment of the tube where it opens to the uterus.
Most obstructions occur at the fimbriated end of the fallopian tube, where the finger-like projections of the fallopian tubes help direct the egg into the uterus. Of particular concern, fimbriated obstructions can lead to fluid build-up in the fallopian tube, resulting in a hydrosalpinx.
Hydrosalpinx will significantly impact IVF success rates and Dr. Rispler almost always recommends surgical removal for couples trying to conceive.
Dr. Rispler can determine the patency (openness) of the fallopian tubes by injecting dye into the uterine cavity and observing through x-ray examination whether a normal flow through the tubes occurs.
An HSG does not always provide a conclusive reading, so Dr. Rispler may order further testing. Some patients benefit from minimally invasive laparoscopy to examine and repair blocked fallopian tubes.
Infertility may be the first sign that infection from a sexually transmitted disease like Chlamydia has damaged the fallopian tubes.
Surgical reconstruction of blocked or damaged fallopian tubes
Some couples choose to pursue surgery to repair tubal abnormalities or to reverse a tubal ligation. Attempts to conceive after extensive surgery are successful in approximately 30 percent of cases. Oftentimes, reconstructive surgery is covered under insurance, while IVF is not.
A successful outcome of fallopian tube reconstruction surgery depends on many factors, including the severity of the damage, maternal age and the length and location of the tube to be restored.
Talk with Dr. Rispler about the best approach to protect fertility when a diagnosis involves tubal abnormalities.
Dr. Rispler may recommend IVF rather than reconstructive surgery to increase the chances of a successful pregnancy.
For couples presenting with tubal abnormalities, statistics show that in-vitro fertilization (IVF) may be the best option for achieving a successful pregnancy.
Essentially, IVF eliminates the stages of conception that take place in the fallopian tube.
With IVF, eggs, removed surgically from the ovaries, and sperm are combined in the lab for fertilization. Dr. Rispler transfers the resulting embryo(s) directly to a woman’s uterus.
A fertility workup at Innovative Fertility Center will confirm whether tubal abnormalities exist. Dr. Rispler will present several treatment options along with corresponding success rates. Contact us to schedule a consultation and to formulate a fertility treatment plan that eliminates fallopian tube blockages, paving the way for a successful pregnancy.
