Fallopian Tubes

The fallopian tubes are the tubes that carry the egg on its way to meet the sperm.  When the sperm and egg meet in the fallopian tubes, hopefully, fertilization happens.  The fertilized egg then travels down the fallopian tube into the uterus where it implants.

Problems with the fallopian tubes can cause infertility.  If the tubes are blocked or not functioning correctly then the egg and sperm will not meet and pregnancy will never happen.  

Sometimes the tubes can be partially blocked.  This can lead to a dangerous condition called an ectopic pregnancy.  An ectopic pregnancy happens when the egg is fertilized but gets trapped in the fallopian tube.  As a result, the fertilized egg grows in the tube instead of the uterus.  The tube is not meant to hold a pregnancy and can rupture (break open).  This can result in serious complications.

Risk factors for having a fallopian tube problem are: history of ectopic pregnancy, previous tubal or pelvic surgery, ruptured appendicitis, pelvic infection, endometriosis and sexually transmitted diseases such as chlamydia and gonorrhea.  

There are two main tests to evaluate the fallopian tubes.  They are laparoscopy with chromopertubation and hysterosalpingogram (HSG).

Treatment for tubal factor infertility includes surgery (as discussed below) and IVF.  For some types of tubal factor infertility, such as a hydrosalpinx, the most effective treatment is a combination of both surgery and IVF.  For more information on IVF and IVF costs please click on the links.  We offer patient financing and multiple affordable IVF plans including money back guarantee plans.

Laparoscopy

Laparoscopy is a surgical procedure in which several small (about half an inch to an inch) incisions are made in the abdomen.  A camera is placed through one of the incisions and long, thin instruments are place through the other incisions. The camera is used to visualize the pelvic organs while the instruments are used to retract and operate as needed. 

Laparoscopy is usually done on an outpatient basis.  Patients usually go home the same day.

Laparoscopy can be done for many reasons.  It can be done for purely diagnostic reasons to determine if there are pelvic adhesions, endometriosis, fallopian tube issues or a whole host of other issues present that can affect the pelvis and fertility.  It can also be done for corrective reasons.  Surgery can be used to treat pelvic pain, endometriosis, pelvic adhesions, and remove or fix the fallopian tubes etc.

Chromopertubation can be done during laparoscopy.  Chromopertubation is used to determine if the fallopian tubes are open.  A catheter is placed in the uterus. Then blue dye is infused into the catheter.  The camera that was placed in the abdomen, as part of the laparoscopy, is used to directly view the fallopian tubes and dye.  If the dye fills up and spills out the tubes (fill and spill) then we know the tubes are open.

Chromopertubation is considered the “gold standard” or best test to evaluate the fallopian tubes.  However, it is usually not the first test performed because it requires surgery while a hysterosalpingogram does not.  

Hysterosalpingogram   

A hysterosalpingogram (HSG) is a test to evaluate the fallopian tubes.  The test can be done under ultrasound guidance in the office or under x-ray guidance at one of the local hospitals.  It does not require surgery.  Therefore, it is much less invasive than a laparoscopy.  The largest downside to the HSG is that some patients have significant discomfort with the procedure.

A traditional HSG is done under fluoroscopic (x-ray) guidance.  A catheter is placed in the uterus and contrast (dye that can be seen on x-rays) is infused into the uterus.  Several x-rays are taken and the physician can observe if the dye fills up and spills out of the tubes (fill and spill).  

A newer test is called a SonoHSG.  This is the test we most often perform at the Advanced Reproductive Center.  It is done under ultrasound guidance so it avoids having to expose patients to x-ray radiation.  Similar to a traditional HSG a catheter is paced in the uterus.  Saline and water are infused through the catheter.  This creates air bubbles.  An ultrasound is performed and we can see if the air bubbles fill up and spill out of the tubes (fill and spill).  

If fill and spill occurs we know that the tubes are open.  If this does not happen the tubes may or may not be truly blocked.  There are many reasons such as tubal spasms which can cause what appears to be a true blockage even though the tubes are open.  Sometimes if a HSG is abnormal, a laparoscopy and chromopertubation are performed to see if a true blockage is present.

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