Washington Center for Reproductive Medicine

Tubal Disease

Once the eggs mature and are ovulated, they travel from the ovary, through the fallopian tube, to the site of fertilization at the end of the tube.  Eggs must be able to make their passage without obstruction.

Tubal disease results when the fallopian tubes are damaged, or obstructed, thus impeding egg transport.  There are many potential causes of tubal disease including endometriosis, scarring from previous surgery, severe pelvic infections, or it can be congenital. Endometrial implants can attach to the tubes, grow, and even penetrate the tubal structures.

The hysterosalpingogram (HSG) is a common fertility test used to rule out tubal disease. The HSG is an outpatient procedure involving injecting radio opaque dye into the uterus and observing its passage through the uterine cavity and fallopian tubes using x-rays. If there is a blockage in the tube(s), the dye cannot pass and this is clearly visualized. Deformities in the uterus can also be detected by this technique.

Some women seek reversal of a previous tubal ligation (cut tubes) performed for birth control. Sometimes the tubes can be reconnected be a skilled surgeon, depending upon how and where they were cut, the presence of scar tissue and other factors. In vitro fertilization is an option for these couples since the eggs are retrieved surgically and don’t have to make the passage through the fallopian tubes. Per cycle success rates are higher using IVF in most couples. Even though pregnancy is possible after a tubal ligation, the procedure should be considered a permanent means of birth control.

In many cases, the tubes are severely damaged making IVF the only effective treatment option. The eggs are retrieved directly from the ovaries and fertilized in the laboratory, which eliminates the need for tubal egg transport.  Success rates using IVF are typically higher than tubal reanastamosis. This depends upon many factors including, other causes of infertility that may be present, age of the female, treatment history, and other variables.












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