Tubal Disorders
Diseases of the fallopian tube are a relatively commmon cause of infertility. Once the eggs are released from the follicles on the ovary, they must travel unimpeded through the fallopian tubes to the uterus. Any blockage, or other damage to the fallopian tubes, can prevent passage of the egg.Tubal disease is a common cause of infertility. The tubes must be open in order to transport eggs from the ovaries to the uterus. Tubal blockage can occur because of infection (pelvic inflammatory disease), scarring from previous surgery, congenital defects, endometriosis, or other conditions. In many, if not most, cases in vitro fertilization is the "therapy of first choice" for tubal disease because success rates are higher.
This is also true in most cases where reversal of tubal sterilization is desired (dependent upon where and how the tubes were tied). If the fallopian tubes are blocked and dilated this is called a hydrosalpinx. Once the tubes are dilated, the chance for successful tubal reconstructive surgery is small and the risk of ectopic pregnancy is high. The fluid present within the hydrosalpinx contains many toxins released from dying cells that line the fallopian tube. This fluid has been shown to be toxic to embryos. Also, this fluid occasionally leaks backwards from the tube into the uterine cavity. For this reason, many fertility specialists recommend having the hydrosalpinges removed surgically prior to doing in vitro fertilization (IVF). This procedure can be done laparoscopically as an outpatient. The removal of the fallopian tubes that are dilated and damaged can double the pregnancy rates with IVF.
This is also true in most cases where reversal of tubal sterilization is desired (dependent upon where and how the tubes were tied). If the fallopian tubes are blocked and dilated this is called a hydrosalpinx. Once the tubes are dilated, the chance for successful tubal reconstructive surgery is small and the risk of ectopic pregnancy is high. The fluid present within the hydrosalpinx contains many toxins released from dying cells that line the fallopian tube. This fluid has been shown to be toxic to embryos. Also, this fluid occasionally leaks backwards from the tube into the uterine cavity. For this reason, many fertility specialists recommend having the hydrosalpinges removed surgically prior to doing in vitro fertilization (IVF). This procedure can be done laparoscopically as an outpatient. The removal of the fallopian tubes that are dilated and damaged can double the pregnancy rates with IVF.
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