Tubal Abnormalities
The fallopian tubes are two hollow “tubes” attached to the left and right side of the uterus. Each tube extends from the uterus to the ovary and their function is to catch the egg as it is released from the ovary. The ends of the fallopian tube are flared and have delicate fingerlike structures called fimbriae. When the ovary releases an egg or oocyte, the fimbriae pick up the egg and direct it into the tube. As the egg passes through the fallopian tube the egg receives nutrition and a perfect environment for fertilization. Egg and sperm usually meet in the distal portion of the tube, where fertilization occurs. It is vital that the fallopian tube is open and functioning properly to allow egg and sperm to meet and the fertilized egg to move to the uterus for implantation.
Tubes that have been damaged by previous infection or endometriosis can severely affect a couple’s chance for pregnancy. There are also congenital abnormalities of the fallopian tubes that can make egg pick up difficult.
Tubal Blockage
Women who have had pelvic infections, surgery or endometriosis which involve inflammation can cause scarring around the uterus and fallopian tubes. Women who have had an ectopic pregnancy can also have tubal blockage. Blockage can be caused by various other conditions such as:
- Pelvic infections (such as pelvic inflammatory disease and sexually transmitted diseases)
- A ruptured appendix or surgery in the pelvis or lower abdomen
- A tubal or ectopic pregnancy in the fallopian tubes
- Malformation of the fallopian tubes
- Endometriosis
- Pelvic adhesions between normally unconnected structures in the uterus or pelvis
- Congenital abnormalities
Hydrosalpinx
A blocked fallopian tube that becomes filled with liquid is called a hydrosalpinx. These not only cause infertility, but can also reduce the effectiveness of other infertility treatments. The condition occurs when injury to the fallopian tube, usually from infection, causes the end of the tube to close. As a result, fluid collects in the tube and causes it to swell. This fluid would normally leak out the end of the tube but since the tube is blocked it actually leaks back into the uterus. This fluid has been shown to decrease the chances for conception by a significant amount. If an embryo is implanted in the uterus using IVF this tubal backflow into the uterus can decrease the chances for success by one third to one half unless treated ahead of time.
The most common symptom of tubal blockage is infertility.
Diagnosis of Tubal Damage
Tubal factor infertility is a very common problem and because of this we routinely test to determine if the tubes are open and undamaged as a part of the normal fertility workup. At IVF Plano we routinely use one of two types of diagnostic tests to check for tubal patency a hysterosalpingogram (HSG) and a surgical procedure, diagnostic laparoscopy.
