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Tubal Surgery

The role of fallopian tube is to pick up the egg released form the ovary, allow the sperm to travel through it, provide site for fertilization. Once the egg is fertilized, the resulting embryo must travel from the fallopian tubes to the uterus in order for pregnancy to occur. Damaged or blocked fallopian tubes can prevent a woman from getting pregnant by interfering with the movement of the sperm to the egg or the fertilized egg to the uterus. About 20-30% women with infertility have tubal problems.

Tubal blockages or damage may be caused by pelvic inflammatory disease, endometriosis, previous surgeries, ectopic pregnancy or tubal ligation. Most women with damaged or blocked fallopian tubes do not experience any symptoms.

Diagnosing damaged or blocked fallopian tubes: There are three methods of diagnosing tubal problem.

  1. hysterosalpingogram (HSG) test
  2. saline sonogram (HyCoSy)
  3. laparoscopy and dye test

There are several types of treatment for damaged or blocked fallopian tubes are available. Though these procedures are aimed to open the tubes, one must remember open tube is not equivalent to a functional tube. The pathology causing the blocked tube significantly affects physiological function of the tube affecting reduced success rate following surgery and increasing risk of ectopic pregnancy.

Tubal reanastomosis is often used to reverse a tubal ligation or to repair a part of the fallopian tube damaged by disease. The blocked or diseased part of the tube is removed. Then the two healthy ends of the tube are joined. The outcome of such surgical procedure depends on condition of the residual tube. Also there is a significant risk of ectopic pregnancy post surgery.
Salpingectomy is the removal of part of a fallopian tube. It’s done to improve IVF success when a tube has a build-up of fluid inside the tube known as hydrosalpinx. Hydrosalpinx reduces the success of IVF procedure. Salpingectomy is preferred over salpingostomy for treating a hydrosalpinx before IVF.
Salpingostomy is also done when the end of the fallopian tube is blocked by a build up of fluid. This procedure creates a new opening in the part of the tube closest to the ovary. But it’s common for scar tissue to regrow after a salpingostomy. This can reblock the tube.
Fimbrioplasty may be done when the part of the tube closest to the ovary is partially blocked or has scar tissue. These problems can prevent normal egg pickup. This procedure rebuilds the fringed ends of the fallopian tube.

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