Fallopian tube obstruction

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Fallopian tube obstruction
Gynecology

Fallopian tube obstruction, also known as fallopian tube occlusion, is a major cause of

ovum and the sperm converge, thus making fertilization
impossible.

Types

Approximately 20% of female infertility can be attributed to tubal causes.

Proximal tubal obstruction can occur after infection such as a septic abortion
.

Causes

Most commonly a tube may be obstructed due to infection such as

HIV infection.[2]

Fallopian tubes may be blocked as a method of contraception. In these situations tubes tend to be healthy and typically patients requesting the procedure had children. Tubal ligation is considered a permanent procedure.[citation needed]

Diagnosis

While a full testing of tubal functions in patients with

hysterosalpingogram will demonstrate that tubes are open when the radioopaque dye spills into the abdominal cavity. Sonography can demonstrate tubal abnormalities such as a hydrosalpinx indicative of tubal occlusion. During surgery, typically laparoscopy, the status of the tubes can be inspected and a dye such as methylene blue can be injected in a process termed chromotubation into the uterus and shown to pass through the tubes when the cervix is occluded. Laparoscopic chromotubation has been described as the gold standard of tubal evaluation.[3] As tubal disease is often related to Chlamydia infection, testing for Chlamydia antibodies has become a cost-effective screening device for tubal pathology.[3]

Tubal insufflation is only of historical interest as an older office method to indicate patency;[4]
it was used prior to laparoscopic evaluation of pelvic organs.

Treatment

Treatment of fallopian tube obstruction has traditionally been treated with fallopian tubal surgery (

in vitro fertilization as it is more cost-effective, less invasive, and results are immediate. Alternative methods such as manual physical therapy are also cited for the ability to open and return function to blocked fallopian tubes in some women. Treatments such as assisted reproductive technologies are used more often than surgery.[5]

Tuboplasty

Main article: Tuboplasty

Tuboplasty refers to a number of surgical operations that attempt to restore patency and functioning of the

in vitro fertilization (IVF).[citation needed
]

Different types of tuboplasty have been developed and can be applied by

salpinostomy (creating an opening for the tube)[9] or falloposcopy
.

Results of tubal surgery are inversely related to damage that exists prior to surgery.[10] Development of adhesions remains a problem.[1] Patients with operated tubes are at increased risk for ectopic pregnancy,[10] although in vitro fertilization in patients with damaged tubes is also associated with a risk for ectopic pregnancy.

In vitro fertilization

Main article:
In vitro fertilization

In vitro fertilisation is a process by which

ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilise them in a fluid medium in a laboratory. When a woman's natural cycle is monitored to collect a naturally selected ovum (egg) for fertilisation, it is known as natural cycle IVF. The fertilised egg (zygote) is then transferred to the patient's uterus with the intention of establishing a successful pregnancy.[citation needed
]

While IVF therapy has largely replaced tubal surgery in the treatment of infertility, the presence of hydrosalpinx is a detriment to IVF success.[5] It has been recommended that prior to IVF, laparoscopic surgery should be done to either block or remove hydrosalpinges.[11]

References

  1. ^
    ISBN 0-7216-6897-6.[page needed
    ]
  2. S2CID 38319728
    .
  3. ^
    S2CID 43312882
    .
  4. PMID 17229327
    .
  5. ^
    PMID 19826575
    .
  6. ^ "Fallopian Tube Procedures for Infertility". Web MD. Retrieved 20 August 2013.
  7. S2CID 33208955
    .
  8. ^
    PMID 2107667
    .
  9. PMID 2957240
    .
  10. ^
    PMID 16433156
    .
  11. PMID 33091963
    .

External links

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