Tubal Causes

 

Fallopian tube blockage prevents the egg from passing through and also prevents the sperm from reaching the egg. The sperm and egg usually meet in the fallopian tube where fertilization typically occurs. Tubal blockage can be caused by scar tissue, infection, hydrosalpinx, congenital abnormalities, fibroids, tubal ligation, and very often no obvious cause.

Tubal Reanastamosis:

This procedure is done to repair the fallopian tubes after a tubal ligation was performed. This procedure can be done via a laparoscopy (key hole surgery) or through a laparotomy (open surgery). Typically when done via Laparotomy the surgery is done under a microscope for more accurate suturing and a higher success rate.

Salpingectomy:
 
Is a procedure where the fallopian tubes are surgically excised and removed. Unfortunately the only method of achieving a pregnancy after removal of both tubes is In-Vitro Fertilization (IVF). See hydrosalpinx to see importance of this surgery and why it increases the probability of achieving a pregnancy with IVF.

Salpingostomy:

An alternative to salpingectomy (removal of the fallopian tubes) is a procedure called salpingostomy. Salpingostomy is essentially the attempt to reopen the fallopian tube surgically in the hopes that the fallopian tubes heal well and remain open. This method has the risk of the fallopian tubes reclosing and hydrosalpinx reforming. It also has the risk of causing an ectopic pregnancy (a pregnancy in the fallopian tube). Some physicians will perform this procedure if the hydrosalpinx is considered mild and the fimbria at the end of the fallopian tube appear relatively healthy.

Fimbrioplasty:

This surgery is performd on the fimbria (the ends of the tube that are responsible for picking up the egg (oocyte). This procedure attempts to reopen the fimbria. This procedure is very successful when the patient is diagnosed with minor scar tissue in the pelvis.

Fallopian Tube Cannulation:

This procedure is performed on the proximal portion of the fallopian tube (the part of the tube that is in the uterus or near the uterus). A small catheter is typically passed into the fallopian tube unblocking it. The physical unblocking can be done with a wire or with a plastic catheter. When a catheter is used, water is pushed through the tube to perform the unblocking. This procedure can be done via fluoroscopy or hysteroscopy. Flouroscopy is done with X-ray, hysteroscopy is a procedure where a camera is passed into the uterus (via the cervix) and the catheter is passed under direct visualization. Another common name for this procedure is "NOVY Cornual Cannulation".