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Getting pregnant can be tough no matter what, but for those dealing with blocked Fallopian tubes, the challenges may be a bit more difficult to overcome.
Essentially, Fallopian tubes must be open, have no swelling, and be free of scar tissue to function properly. With at least one tube in a healthy condition, having a natural or IUI-assisted pregnancy is certainly possible. On the other hand, if both tubes are experiencing problems, there are several procedures that can be done to mitigate issues and achieve positive results.
Here's what you need to know about blocked Fallopian tubes and how to increase your chances of starting a family with fertility treatment options:
Blockages can occur in the Fallopian tubes for a number of reasons, but the most common cause is pelvic inflammatory disease (PID).
Typically the result of a sexually transmitted disease, PID is a bacterial infection of the reproductive organs that affects the uterus and Fallopian tubes. The infection may lead to pelvic pain, abscess growth, scarring from adhesions, and may even cause an ectopic pregnancy if left untreated.
Additional causes of blocked Fallopian tubes include an ongoing or past experience of...
There are several ways to test for Fallopian tube blockages that are fairly routine without too much recovery time afterward.
Three main procedures that check for tubal swelling or obstructions are hysterosonograms (HSN), hysterosalpingograms (HSG), and laparoscopy with chromotubation of the tubes.
An HSN is a type of high-resolution ultrasound used with saline solution, rather than dyes and x-rays.
The process is less demanding on the body and offers a clear visual representation of the uterus, allowing a specialist to see any abnormalities within it. However, gaining a thorough look into the Fallopian tubes is somewhat limited.
An HSG provides a more in-depth look into the Fallopian tubes through the use of an iodine liquid filled into the uterus, which is contrasted by an x-ray that shows you how the liquid moves throughout your reproductive system.
This process is fairly quick altogether, typically taking less than 10 minutes, and patients can return home shortly after. With that in mind, it has been known to cause cramping and may be a secondary course of action for those who need further review of their Fallopian tubes.
Being the most demanding procedure of the three, a laparoscopy with chromotubation is an inpatient procedure carried out with general anesthesia.
Two incisions are made, one for a fine telescope (laparoscopy) to be inserted into the abdomen, and another in the pubic region for a small probe to provide an obstructed view of the reproductive organs. Once everything is in place, the chromotubation process (dye test) begins, filling the womb with a light-blue liquid. If the Fallopian tubes are open, then the dye will spill from the ends into the pelvis area, but if nothing comes out, then a blockage is usually the issue.
After this procedure, it takes approximately one week to recover.
Similar to laparoscopy with chromotubation, blockages within the Fallopian tubes can be temporarily fixed with a process called tubal cannulation.
Tubal cannulation uses two types of surgical procedures called hysteroscopy and laparoscopy.
Through a small incision of the abdomen, a narrow tube outfitted with a camera and light source is inserted into the womb. Next, a thin wire (cannula) is guided through the Fallopian tube, creating an opening and clearing blockages. Once complete, a dye is sent through the womb to see if it can pass through the Fallopian tubes without being deterred. It if flows freely, the surgery is a success.
According to research from Saint Mary's Hospital in the UK, 75% of women who undergo tubal cannulation are successful in getting pregnant between 22% and 33% of the time. However, a downside to the procedure is that Fallopian tubes cannot be reopened permanently and may reclose at a later date.
Yes, you can get pregnant naturally or with the assistance of an IUI with one Fallopian tube open. However, if both tubes are blocked, then an in vitro fertilization (IVF) may be required.
In vitro fertilization (IVF) works around blocked Fallopian tubes by developing the embryo outside of the body in a controlled laboratory setting and transferring it to the uterus through a small insemination catheter. Over time, the embryo grows naturally in the same fashion as a traditional pregnancy without relying on the Fallopian tubes to function.
With that in mind, a condition known as hydrosalpinx (swollen tubes) can have an effect on the outcome of an IVF, leading to a 50% reduction of its success. Also, anyone who has had a tubal ligation (tubes tied) may have trouble finding success with an IVF, although a tubal reversal is possible.
In any case, it's always best to consult with a fertility specialist before deciding to undergo any procedures.
At Kofinas Fertility Group, your health is always a priority, and any challenges you may have with blocked Fallopian tubes will be fully assessed to ensure the right course of action that leads to you having the family of your dreams.
Fertility Surgery is a group of procedures aimed at removing female and male barriers to natural conception. In an age where In-Vitro Fertilization (IVF) has become common and very widely used, it is easy to forget the essential role that fertility surgery can play in the ability of a couple to achieve a pregnancy. There is a big difference between non-surgical fertility treatment options and actual fertility surgery. The former—which you might also hear called “non-surgical” or simply “medical” fertility treatment—can include a wide variety of options that you choose with the guidance of your doctor, and may include ovarian stimulation medications, intrauterine insemination (IUI), or cycle monitoring and stimulation.
Fertility surgery, on the other hand, is more likely to treat more serious conditions that may prevent you from getting or staying pregnant. Some of these conditions for example include uterine fibroids, adhesions, and endometriosis. For men, repair of dilated veins in the scrotum and reversal of vasectomies can overcome anatomic barriers to male fertility. In the article entitled “A Prospective Controlled Study of the Effect of Intramural Uterine Fibroids on the Outcome of Assisted Conception” published in the peer-reviewed journal Human Reproduction in 2001, Hart, Khalaf, Yeong, Seed, Taylor, and Braude showed that fibroids located in the wall of the uterine body halved the rates of successful pregnancy in assisted conception cycles. Besides decreasing the ability of couples to achieve pregnancy, fibroids are associated with miscarriage and early loss of an otherwise viable pregnancy.
Endometriosis is another reproductive condition that has profound effects on a woman’s fertility and reproductive life span. Endometriosis is a condition that can cause severe pain with menses, pain with intercourse and irregular vaginal bleeding. The mechanism of pain is most likely due to significant inflammation in the uterine pelvis leading to the release of substances that can cause severe pain. The presence of endometriosis in some women versus others is a mystery although an anatomic as well as an immunologic based theory of disease is gaining significant traction. The biggest concern we fertility doctors have is how to identify those women who have endometriosis and how to best preserve their fertility and/or assist them in reproducing. In a study published in the peer-reviewed journal Fertility and Sterility in the summer of 2018, Kasapoglu, Ata, Uyaniklar, Seyhan, Orhan, Oguz, and Uncu showed that women with stage 3 or 4 endometriosis (severe) defined by the presence of an endometrioma (ovarian cyst) have a significantly higher and rapid reduction in ovarian reserve. This leads to impairment of reproductive potential at a much younger age than a healthy control population. Endometriosis is a progressively destructive condition and can be treated effectively with fertility surgical intervention. This should restore natural fertility and decrease the progressive decline in reproductive potential.
When used appropriately, fertility surgery can be a safe and effective restoration of a couple’s fertile potential. It can completely eliminate the need for IVF which is an expensive and difficult treatment that for the conditions listed above has significantly lower success rates. Proper diagnosis and treatment of a couple leads to better treatment outcomes and fertility surgery continues to play a large role. #
Dr. Jason D. Kofinas is the Director of IVF and Research at Kofinas Fertility Group.
Originally posted on Education Update Online in their March/April 2019 edition.