Tubal Disease and Infertility

The providers at Advanced Reproductive Medicine & Gynecology of Hawaii have evaluated and treated many women for fallopian tube abnormalities causing infertility. Although the infertility treatment options with tubal disease are limited often requiring IVF, the pregnancy rates for women with tubal disease undergoing IVF are very good.

One of the many causes of infertility is tubal disease, in which your fallopian tubes become blocked or damaged. Scar tissue resulting from endometriosis or abdominal or gynecological 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 tube.

Tubal ligation (having your “tubes tied” to prevent pregnancy) can also leave your fallopian tubes damaged. However, reconstructive surgery to reverse tubal ligation is often successful.

How tubal disease is diagnosed

Your medical history and a pelvic exam are necessary in diagnosing tubal disease. However, other tests are needed to confirm the diagnosis. You may need one or more of the following tests:

• Sonohysterogram – a procedure that uses ultrasound to detect masses in your uterus that may be blocking your fallopian tubes.
• Hysterosalpingogram – a procedure that uses x-rays and a special dye injected into your fallopian tubes, to see if they are open or blocked.
• Sonohysterosalpingogram – This procedure uses a mixture of saline and air bubbles injected into the fallopian tubes to see if they are open or blocked. An ultrasound is used for visualization of the fallopian tubes.

• Laparoscopy – an outpatient surgical procedure in which your doctor uses a narrow fiberoptic telescope inserted through an incision near your navel to look for and sometimes remove scar tissue or endometrial tissue blocking the fallopian tubes.