Obstruction of the fallopian tubes causes problems with getting pregnant in every fourth Polish couple. Obstruction of the fallopian tubes usually occurs as a result of inflammation of the genital tract, which leads to thickening of the walls of the fallopian tubes and adhesions that block the sperm from entering the egg. How is obstruction of the fallopian tubes treated?

Obstruction of the fallopian tubesis a very common cause of infertility.Treatment of obstruction of the fallopian tubesdoes not always have a chance of success, sometimes the only solution is to take advantage of the benefits of IVF. What are the causes of obstruction of the fallopian tubes and how is it diagnosed?

Obstruction of the fallopian tubes: causes

  • inflammation caused by infections (chlamydia, mycoses, gonorrhea)
  • endometriosis
  • ectopic pregnancy
  • miscarriage
  • tumors of the fallopian tubes
  • surgical operations in the abdominal cavity (e.g. appendectomy)
  • contraceptive IUD

Obstruction of the fallopian tubes: diagnostic tests

The easiest way to detect obstruction is by means of the so-called hysterosalpingography (HSG). This test assesses not only the patency of the fallopian tubes, but also the structure of other reproductive organs. Hysterosalpingography involves the administration of a contrast agent through the cervical canal to the uterus and fallopian tubes and simultaneous taking X-rays at individual stages of the examination.

As the contrast agent travels through the reproductive organs, it is possible to see and evaluate the structure of the uterus, detect birth defects, intrauterine adhesions, polyps and fibroids, and assess the patency of the fallopian tubes. It sometimes happens that the examination itself causes a small adhesion to be unsticked.

Important

How are fallopian tubes built?

The fallopian tubes are 15-20 cm long tubes supported by the mesentery (mesosalpinx) that extend from the uterus and "capture" an egg from the ovary. Most of the cells in the fallopian tube epithelium have cilia which move towards the uterus, thus transporting the egg. The embryo may develop into the blastocyst stage before entering the uterus. The fallopian tubes are divided into several parts:

  • intramural part: the narrowest part of the fallopian tube that lies within the wall of the uterus and formsinternal opening of the fallopian tube;
  • isthmus: located close to the uterine wall;
  • bulb: the farthest part of the fallopian tube, lateral to
  • isthmus where the egg is fertilized and the zygote divides early;
  • funnel: the part of the fallopian tube formed by the hyphae in the form of a tube that opens towards the peritoneal cavity, which forms a wide surface prepared to receive an egg.

They are used to transport sperm to the fallopian tube, where the egg is fertilized and the embryo develops, which then goes to the uterine cavity. The mucosa of the fallopian tube is intensely folded and the diameter of the fallopian tube is very small, i.e. at the point where it enters the uterine cavity, it is only 0.5 mm. Therefore, even the slightest narrowing can cause complications, and hence - a problem with getting pregnant.

Obstruction of the fallopian tubes: treatment

Until recently, surgery was often performed in such cases. the so-called laparoscopic tubal plastic surgery. Using microscopic tools, doctors remove the adhesions from the fallopian tube and shape it so that it regains its original shape, but this will not always be effective. Doctors suggest this procedure when:

  • there are adhesions around the fallopian tubes,
  • there is complete obstruction of the fallopian tubes in their final segment, i.e. near the ovary (operated under a microscope),
  • there is partial obstruction of the outer end of the fallopian tube,
  • there is an obstruction in the part of the fallopian tube that connects to the uterus,
  • you suffer from endometriosis, which may cause obstruction or extensive scarring,
  • reverse sterilization planned

Since this procedure does not restore the function of the diseased fallopian tube, it is usually not effective. For this reason, in vitro fertilization is recommended for women with obstruction of the fallopian tubes (especially after the age of 35).

According to an expertprof. Sławomir Wołczyński, expert of the Center for Studies on Human Fertility

- Two fallopian tubes are usually inflamed and both are damaged. Sometimes it is about one thing, such as when a hydrocele develops. The oviduct is then closed at the ovary and filled with fluid that flows into the uterine cavity. Removal of such a fallopian tube improves fertility, but unfortunately in such a situation the functioning of the other fallopian tube may be impaired. If we find perianal adhesions, and the lumen of the fallopian tube itself is not narrowed, removing them with a laparoscope increases the patient's chance of natural conception.

Category:

Pregnancy