CIGC Infertility Series Part III: The Function of the Fallopian Tubes
The fallopian tubes are very delicate structures that connect the ovaries to the uterine cavity. The ovaries produce eggs that are released. The fallopian tube end is like a suction cup that “vacuums” up the egg. If intercourse occurs at the right point, sperm will meet the egg in the tube, and they will join together forming an embryo. The embryo will then travel down the tube to the uterine cavity where it will implant into the lining of the uterus to allow for pregnancy.
Understand the Causes of Fallopian Tube Blockages and How they Lead to Infertility
There are many causes for blockage of the fallopian tubes. Pelvic infections are a common cause, as are fibroids obstructing the tubes or prior surgery causing scarring to the tubes. In general, if the tubes are blocked most fertility doctors will recommend in vitro fertilization (IVF), to bypass the tubes to become pregnant. With IVF, eggs from the ovaries are harvested and mixed with sperm to form embryos. These embryos are then transferred to the uterine cavity through the vagina to allow for implantation and pregnancy. Tubal reconstruction is rarely used for blocked tubes, since the success rates for this procedure are less than 50% even in the best hands.
Ligation of the Tubes Improves IVF Success Rates
For those patients undergoing IVF with fluid collections in the tubes, it is generally recommended that the tube be removed or “ligated” to prevent fluid from travelling down the tube and preventing implantation of the embryo in the uterine cavity. For example, if there is a blockage in the fallopian tube at the end of the tube, fluid will build up in the tube, also known as a “hydrosalpinx”. (Hydro – water, salpinx – tube). This fluid is toxic, and can prevent the implantation of the embryo into the uterine lining up to 60% of the time. It is essential that any IVF patient with a hydrosalpinx has the tube either removed or ligated to stop the flow of toxic fluid to the cavity, thereby increasing the implantation rate. Many of these procedures can be complex due to extensive scar tissue from infection or prior surgery. Always consider a surgical specialist like those at The Center for Innovative GYN Care, to ensure the tube/s are treated safely, and to decrease the complications associated with these difficult procedures.