One of the many causes of infertility is tubal disease, in which one or both of your Fallopian tubes becomes blocked or damaged.
Causes of Tubal Disease
Scar tissue resulting from endometriosis or abdominal or gynecologic surgery (bowel surgery, cesarean section, ruptured appendix, etc.) can block the egg from entering or traveling down your Fallopian tube to meet the sperm. Infections, such as chlamydia, can damage the cilia (tiny hairs lining the Fallopian tubes) that help to transport the egg. Without normal cilia, the egg may not meet the sperm, or if an egg becomes fertilized, it may not be able to travel to the uterus. This can result in an ectopic pregnancy, which can further damage your Fallopian tube.
In addition, tubal ligation (having your "tubes tied" to prevent pregnancy) can also leave your Fallopian tubes damaged.
diagnostic tests for tubal disease
Your medical history and a pelvic exam are necessary for diagnosing tubal disease. However, your physician may need other tests to confirm the diagnosis such as:
A procedure that uses ultrasound to detect masses in your uterus that may be blocking your Fallopian tubes.
A procedure that uses x-rays and a special dye injected into your Fallopian tubes to see if they are open or blocked.
An outpatient surgical procedure in which your doctor uses a narrow fiber-optic telescope inserted through an incision near your navel to look for—and sometimes remove—scar tissue or endometrial tissue blocking the Fallopian tubes.
treatment for tubal disease
If scar tissue in or around your Fallopian tubes is causing the problem, your doctor can often remove it surgically. If your Fallopian tubes are damaged, your doctor may be able to repair them using surgery, depending on the type and extent of the damage. If your tubal disease is severe, you may want to consider in vitro fertilization (IVF)—a procedure in which a physician removes eggs from your ovaries, mixes them with your partner's sperm, and then places one or more embryos into your uterus—thereby bypassing your Fallopian tubes.
What can you tell me about reversing tubal ligation?
Reversing your tubal ligation is a major surgery that is most frequently performed by laparotomy, through an incision in the abdominal wall. It is a lengthy procedure that often requires the use of a surgical microscope (called microsurgery). You can expect a stay in the hospital and a few weeks off from work. It will be several weeks before you can resume your normal activities. Undergoing IVF to conceive can help avoid the extensive tubal ligation reversal surgery.