Fallopian tubal factor infertility occurs when there is a blockage in the fallopian tubes preventing the egg from meeting the sperm. Blockage of the fallopian tubes, accounts for 30% of infertility diagnoses. These cases range from complete blockages of the fallopian tubes to scar tissue that makes the tubes impassable. Depending on the cause, blockages may occur in one or both tubes.
Exactly What Are Fallopian Tubes and Their Function
Before delving into the cause of tubal factor infertility, we’ll take a look at the fallopian tubes and their function.
The delicate fallopian tubes are hollow connections between each ovary and the uterus. When you ovulate the egg travels through the fallopian tubes toward the uterus. If sperm are present, they maneuver their way toward the egg and fertilization occurs. Fertilization of the egg normally happens inside the fallopian tube, and the tiny, hair-like cilia impel the fertilized egg toward the uterus. The fertilized egg implants in the uterus where it grows and develops into a baby.
What Causes Fallopian Tube Issues That Interfere With Fertility
In addition to an elective tubal ligation (having your tubes “tied”) the main fallopian tube factors impacting fertility are endometriosis and the scar tissue it causes. Abdominal surgeries may also leave scar tissue or severe infections also causing scarring. The infections are typically thought to relate to sexually transmitted infections, however that isn’t always the case.
Although cases of gonorrhea and chlamydia, especially left untreated, cause serious scarring and pelvic inflammation so do other infections. For instance, a severely inflamed or ruptured appendix may result in pelvic infection. And although not very common in the US, tuberculosis is a known cause of tubal blockage. Another of the fallopian tube factors impacting fertility? An ectopic pregnancy that causes scar tissue or an infection in your pelvic region.
Pelvic infections and pelvic inflammatory disease are two of the major causes of fallopian tube blockage. With pelvic inflammatory disease the infection spreads from the cervix through the uterus and into the fallopian tubes. The tubes become scarred making it nearly impossible for an egg to travel to meet the sperm. The tube’s opening becomes partially blocked or in some severe cases, completely blocked.
There aren’t always symptoms with tubal blockages, and you may not notice any issues until you try to conceive. In other cases, you may experience chronic discomfort in your pelvic region. Always alert your doctor when you experience pelvic pain as this is abnormal.
Diagnosing Tubal Infertility
Treatment for fallopian tube blockages that impact your fertility begin once your doctor has a diagnosis. There are two specific procedures doctors use for diagnosing fallopian tube factors impacting your fertility.
- Hysterosalpingogram (HSG): A radiologist performs the HSG. They insert a slim catheter through your vagina into your cervix where the radiologist releases a fluid containing a harmless dye that allows them to see where it travels. The fluid makes its way into your uterus and, ideally, through your fallopian tubes. If there is no blockage, the radiologist sees the fluid flow completely through both tubes. If the fluid doesn’t flow freely through both tubes a blockage is present. One caveat; If the fluid flows through your tubes that doesn’t necessarily indicate your tubes are free from scarring that may prevent the egg from traveling to meet the sperm. The HSG test does not always indicate normal tube function.
- Laparoscopy: A laparoscopy is minimally invasive surgery performed by your doctor. Typically, performed as an outpatient surgical procedure where you are under anesthesia the laparoscopy involves insertion of a scope called a laparoscope through a tiny incision just beneath your belly button. Through this procedure your doctor sees directly into your pelvic area through the scope. They use the scope to look for blockages and scarring on or near your tubes and also see if there is an indication of additional scarring, the presence of infection and endometriosis. These other issues are additional factors impacting fertility.
Treatment For Tubal Factor Infertility
Treatment for fallopian tube factors impacting fertility depends on your history, diagnosis and what you and your doctor decide. The most common options are:
- Tubal Reversal: Of course, those females who’ve had a tubal ligation may opt for a tubal reversal. The success of this procedure depends on many different factors and you and your doctor should discuss them before determining if you are a candidate.
- Surgery: Patients who are younger and for whom the blockages or scar tissue aren’t very severe may consider surgery. However, surgery is not without some serious risks, and you should discuss the risks with your doctor. It’s possible to experience an ectopic pregnancy after surgery that removes scar tissue from your fallopian tubes. This poses a serious risk to your health and future fertility.
- IVF: IVF offers the biggest opportunity for successful pregnancy, especially if there is significant damage to your fallopian tubes. In some cases, especially for those with hydrosalpinx, a condition whereby fluid blocks the fallopian tubes, your doctor may recommend removal of the damaged tubes prior to IVF. Hydrosalpinx may have a negative impact on IVF outcomes.
If you suspect you may have fallopian tube factors impacting fertility, contact LA IVF.