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, the egg and sperm will not meet, and pregnancy will not happen.
Sometimes the tubes are 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 include a history of ectopic pregnancy, previous tubal or pelvic surgery, ruptured appendicitis, pelvic infection, issues with endometriosis, and sexually transmitted diseases, such as chlamydia and gonorrhea.
Two main tests evaluate the fallopian tubes: laparoscopy with chromopertubation and hysterosalpingogram (HSG).
Treatment for tubal factor infertility includes surgery (like laparoscopy) and in-vitro fertilization (IVF). For some types of tubal factor infertility, such as a hydrosalpinx, the most effective treatment is a combination of both surgery and IVF.
Laparoscopy is a surgical procedure in which we make several small (about half an inch to an inch) incisions in the abdomen. We then insert a camera through one of the incisions, and place long, thin instruments through the other incisions. We use the camera to visualize the pelvic organs, while we use the instruments to retract and operate as needed.
We almost always perform laparoscopy on an outpatient basis; patients typically go home that same day.
There are many reasons we might perform laparoscopy. It can be a useful diagnostic tool to determine if there are pelvic adhesions, endometriosis, fallopian tube issues, or a whole host of other issues that can affect the pelvis and fertility. It can also be a useful corrective tool. Surgery treats pelvic pain, endometriosis, pelvic adhesions, and can also be performed to remove or fix the fallopian tubes.
We can also perform a procedure called “chromopertubation” during laparoscopy. Chromopertubation determines if the fallopian tubes are open. We place a catheter in the uterus, and then infuse a blue dye into the catheter. The camera then goes into the abdomen as part of the laparoscopy, and we can 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, when it comes to evaluating the fallopian tubes. However, it’s not the first test performed because it requires surgery, while a hysterosalpingogram does not.
A hysterosalpingogram (HSG) is a test we use to evaluate the fallopian tubes. We perform the test under ultrasound guidance in the office, or under x-ray guidance at one of the local hospitals. It does not require surgery and is therefore much less invasive than laparoscopy. The most significant downside to the HSG is that some patients have significant discomfort during the procedure.
We perform a traditional HSG under fluoroscopic (x-ray) guidance. We first place a catheter in the uterus and contrast (a dye that shows up on x-rays) is infused into the uterus. We take several x-rays, and the physician can observe if the dye fills up and spills out of the tubes (“fill and spill”).
A newer test is a SonoHSG. This is the test we most often perform at the Advanced Reproductive Center. It uses ultrasound guidance, so we can avoid exposing patients to x-ray radiation. Similar to a traditional HSG, we add saline and water through a catheter inserted into the uterus. This creates air bubbles. We then perform an ultrasound and 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 be blocked. There are many circumstances, such as tubal spasms, that can cause what appears to be a true blockage even though the tubes are open. Sometimes if an HSG is abnormal, we perform a laparoscopy and chromopertubation to see if a true blockage is present.
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Are you having issues with blocked fallopian tubes? It’s time to get help. Call 312.485.4847 today to get the treatment you need from Advanced Reproductive Center. Our caring staff is here to help you with whatever you need.