Obstruction of the fallopian tubes

Causes of fallopian tube obstruction

The most common cause of tube obstruction is the adhesive process in the pelvis. Obstruction is not always diagnosed in the tube itself. If the adhesive process covers both the tube and the ovary, tubal-peritoneal infertility is diagnosed.

The egg cannot move through the tube on its own. Its movement is ensured by contractions of the fallopian tube and movements of microscopic cilia that line the inner surface of the tube. Damage to the cilia can prevent both the fertilization of the egg and the entry of the embryo into the uterine cavity.

Infertility can also occur due to damage to the fimbriae, the thin fringes located at the end of each fallopian tube. Their role is to "capture" an egg coming out of the ovary and send it into the tube.

Factors that cause tubal obstruction

The most common cause of obstruction is a sexually transmitted infection, which causes inflammation. It leads to the formation of adhesions.

Sometimes the adhesive process appears in a woman after surgical treatment on the abdominal cavity or pelvic organs, for example, after removal of appendicitis.

There are other causes of adhesions in the pelvis, such as endometriosis.

Types of fallopian tube obstruction

The obstruction may be:

• full: the pipe is impassable in all its sections.

• partial: the tube is partially passable for contrast media.

Symptoms of tubal infertility and tubal obstruction

In most cases, there are no signs of obstruction of the fallopian tubes. Adhesions, as well as damage to the fimbriae and cilia, do not affect a woman's well-being in any way.

In the case of an inflammatory process, sometimes a woman feels pain in the lower abdomen, general weakness. There may be spotting, an increase in body temperature.

With endometriosis, a woman often experiences pain during sexual intercourse. There may be painful menstruation and sometimes intermenstrual discharge.

Diagnosis of fallopian tube obstruction

When diagnosing tubal obstruction, sonohysterosalpingography (sonoGSG), HSG or laparoscopy can be performed. The choice of technique depends on the patient's medical history.

If a woman has not had gynecological operations or serious inflammatory diseases, the doctor does not find anything during the examination and examination that would indicate the presence of endometriosis, benign growths of the ovaries and uterus, in this case the doctor chooses HSG or sonoGSG.

HSG – X-ray examination. It is performed using a contrast agent that is injected into the uterine cavity. The procedure does not require the use of anesthesia, it causes only minor cramps. However, anesthesia can be applied at the request of the patient.

SonoGSG is similar to GHG, but it is performed not with a contrast agent, but with saline solution and is performed under ultrasound control.

If, after examination, the doctor suspects the presence of other pathologies, laparoscopy is performed - a method of assessing the condition of the uterus, fallopian tubes and ovaries using a laparoscope. The examination is performed through small punctures in the navel area. Over time, the punctures heal without leaving any marks.

Laparoscopy is performed under anesthesia.

During laparoscopy, the doctor not only evaluates the condition of the tubes, but also, if necessary, can remove adhesions and cauterize foci of endometriosis.

Treatment of tubal obstruction

In many cases, the problem can be fixed during laparoscopy. Particularly good results are achieved with partial obstruction. In the case of complete obstruction of the fallopian tubes, surgical treatment is often not effective enough.

If the damage to the tubes is minor, pregnancy after laparoscopy occurs in 50-60% of women. The probability of natural conception largely depends on the condition of the fimbriae. If they are severely damaged, even with absolute patency of the fallopian tubes, pregnancy is unlikely.

To date, treatment of tubal obstruction is impossible without surgery. However, tubal infertility is not a verdict. In vitro fertilization (IVF) successfully solves the problem of women even with complete obstruction of the fallopian tubes. In IVF, the eggs are removed from the ovaries, and the embryos are inserted directly into the uterus. Therefore, the obstruction of the fallopian tubes does not affect the likelihood of pregnancy in this case (of course, unless they diagnose hydrosalpinx or inflammatory

process).

It is believed that after surgical treatment, the tubes remain passable for about 6 months. After this time, the probability of repeated adhesions is very high.

IVF is an effective treatment method even when the tube is removed. Removal may be required, for example, if during the operation the doctor finds the hydrosalpinx – the fallopian tube in the form of a sac-like formation filled with inflammatory exudate.

Advantages of contacting the EMC

• Specialists with experience in the best clinics in Europe. Modern international protocols for the diagnosis and treatment of female and male infertility and other diseases.

• Multidisciplinary approach. We will organize a consultation with the participation of all necessary specialists (gynecologist-reproductologist, endocrinologist, oncologist, etc.).

• Own cryobank of oocytes, sperm and embryos.

• Donor programs (oocytes, spermatozoa, embryos).