IMPAIRED PASSAGE OF FALLOPIAN TUBES

The fallopian tubes are an important part of the female reproductive organs. With special tentacles (called fimbriae), they catch the ovum, which is released from the ovary during ovulation, and ensure its transport to the uterus. They also allow the sperm to travel towards the egg and allow the fertilized egg to be transferred to the uterine cavity. Fertilization occurs in the fallopian tubes.

 What causes tubal obstruction?

Impaired passage of fallopian tubes is most often the result  of inflammation that spreads to the fallopian tubes from the cervix, uterus or directly from the abdominal cavity, e.g. with inflammation of the appendix. The most common causes are: 

  • sexually transmitted diseases (gonorrhea, chlamydia),
  • the consequences of inflammation after operations,
  • endometriosis.

     

How do we determine fallopian tube patency? A normal gynecological examination cannot determine the patency of the fallopian tubes. Possible fallopian tube abnormalities are determined by: 

  • hysterosalpingography (80% sensitivity) 
  • partially, only major abnormalities can be visualised by ultrasound examination
  • in the case of abnormal results of hysterosalpingography and ultrasound, more precisely changes in tube scan be observed with  laparoscopy, with a fallopian tube patency test with blue dye  
     
     

Treatment of blocked fallopian tubes

If possible, blocked fallopian tubes are repaired with a laparoscopic operation called  fimbrioplasty. If successful, the woman can conceive spontaneously. If this is not possible even after surgery, we treat with medically assisted reproductive (MAR) procedures . If a hydrosalpinx is present in the fallopian tube, it is usually removed in MAR procedures, as it represents a chronic source of infection in the uterus. 

The way in which blocked fallopian tubes are treated depends on:

  • degree of damage to the fallopian tubes 
  • sites of tubal obstruction
  • possible previous ectopic pregnancy.
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