Tubal
Disease

The fallopian tubes carry eggs from the ovaries to the uterus. Many women don’t realize that fertilization occurs in the fallopian tubes. When tubes are blocked by scar tissue from endometriosis, surgery or infection, the egg and/or the sperm cannot travel through therefore not allowing fertilization to take place. If a fertilized egg is trapped in the fallopian tube, the result is an ectopic pregnancy, which must be treated with medication or surgery. Tubal problems include:

Infections – sexually transmitted diseases, gonorrhea and chlamydia, often go unnoticed and untreated, causing pelvic inflammatory disease (PID). Serious infection can cause scar tissue and damage the cilia, or small hairs lining the tubes to help the eggs move through. Symptoms of sexually transmitted diseases include inflammation and abnormal discharge. PID can result in pelvic or abdominal pain and severe, untreated infection has been linked to cervical and other cancers, chronic hepatitis and cirrhosis of the liver.

Hydrosalpinges – this condition is caused by a severe blockage – a hydrosalpinx – resulting from infection. It greatly reduces the chance of pregnancy without IVF because it stretches or distorts the fallopian tubes to the extent that they cannot be opened and/or repaired. When the tubes fill with fluid, there is a chance that it can leak back into the uterus. Because this fluid is toxic to embryos placed into the uterus during IVF, physicians often remove or surgically block the tubes before a cycle to improve embryo implantation rates.

Endometriosis – tissue lining the uterus (endometrium) grows and thickens during a menstrual cycle to receive a fertilized egg (implantation). Without a pregnancy, the lining sheds and is discharged with blood during a menstrual period. Endometriosis occurs when this tissue grows outside the uterus and the shedding process deposits blood and tissue in the abdomen. As a result, scar tissue can form in the fallopian tubes, adhere to the ovaries and/or cause misalignment of the organs, preventing natural conception. Although some women have no discomfort even with severe endometriosis, others experience abnormal menstrual bleeding and pain, tenderness in the abdomen and pelvis, and/or painful intercourse.

Tubal Ligation – a form of birth control, this surgical procedure involves tying, clamping off or burning the ends of the fallopian tubes so pregnancy cannot occur.

Treatment Options For Tubal Disease

Medications – including antibiotics, can be effective in treating sexually transmitted diseases and PID. Early diagnosis and treatment are important to avoid further damage. Medications also may be prescribed for endometriosis, to help shrink the tissue that is blocking or distorting the organs.

Surgery – may be an option for opening up and/or repairing tubal damage or blockages from infection, endometriosis, surgery or other factors. Surgery is the only way to reverse a tubal ligation, and it may be recommended to remove or block off the fallopian tubes prior to IVF for a patient with hydrosalpinges.

In Vitro Fertilization (IVF) – required when blockages cannot be removed and/or tubal damage is so severe that it cannot be repaired, IVF is the recommended treatment. The tubes are bypassed during this procedure because the eggs are retrieved from the ovaries and fertilized outside of the body. The embryos are returned directly to the uterus for implantation