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Tubal Abnormalities

Tubal abnormalities are a common cause of infertility.  Often, tubal disease and damage comes from a variety of sources such as infection, sexually transmitted diseases, illnesses involving the abdomen, previous abdominal surgeries, ectopic pregnancies (pregnancies occurring in the tube), and congenital abnormalities.

 To look for problems, Dr. Brown may perform a hysterosalpingogram (HSG), a procedure that can evaluate the uterus as well as tubal patency.  During the HSG, Dr. Brown will insert dye through the vagina and into the uterus.  Because the uterus and fallopian tubes are connected, the dye will flow into the uterus and through the fallopian tubes. Pictures are taken while the dye is instilled, which will help detect problems in the uterus and the fallopian tubes.

 Blocked Tubes

Blocked fallopian tube prevents the oocyte from being released into the uterus.   When the fallopian tube is blocked, the sperm can also not reach the oocyte, preventing fertilization and any chance of pregnancy.

 Pelvic inflammatory disease (PID) is a common cause for blocked tubes and is usually the result of an infection, most commonly a sexually transmitted disease (STD) such as Chlamydia and gonorrhea. Even if PID is resolved, a history of PID can increase the chances of having tubal disease and blocked tubes. Blocked fallopian tubes can also happen due to an infection caused by a miscarriage, pelvic or abdominal surgeries, previous ectopic (tubal) pregnancies, or endometriosis.

Hydrosalpinx

 Hydrosalpinx is a term used to describe the fallopian tube when it is filled with fluid and becomes enlarged. This condition is commonly caused by an old infection such as a sexually transmitted disease (STD). Hydrosalpinx can also be caused by severe pelvic adhesions induced by prior surgeries. Some women experience constant abdominal pain and pressure, and sometimes a vaginal discharge is present.  It is common to have no symptoms at all. 

 As previously mentioned, an HSG is diagnostic tool that can help evaluate whether or not a woman has tubal disease. Sometimes, tubal disease can be detected by ultrasound, but a sonogram cannot explain why a blockage developed or what is causing the tube to be blocked. The only way to know if a woman’s tubes are blocked and determine the cause for the blockage is to perform a laparoscopy, an outpatient surgical procedure that allows your physician to directly visualize the fallopian tubes and determine if a tubal blockage exists. At this time, your doctor may try to repair the damage or blockage to the tube.  The laparoscopy is performed to find out just how good or bad the tube is, and is performed to correct the bad tube and is performed to finally to give the patient a prognosis on her condition.

 Pregnancy rates following surgery to repair a blocked or damaged tube are low. After having surgery to the fallopian tube(s), the risk for having an ectopic pregnancy (located in the fallopian tube) is much higher. In-vitro fertilization (IVF) may be the best options when tubal disease is a major component as it bypasses the need for properly functioning fallopian tubes and has proven success rates.