TUBAL INFERTILITY

Tubal infertility - it is woman`s inability to get pregnant, caused by obstruction of the fallopian tubes. About one quarter of all cases of female infertility is associated with this pathology. Reproductologists, gynecologists and embryologists of the Medical Plaza Medical Center are working together to help women to cope with tubal obstruction and become pregnant safely.

Why does the problem with impregnation occur?

The fallopian tubes (paired organs) have two exits - into the uterine cavity and into the abdominal cavity near the ovaries. During ovulation, the egg leaves the ovary and is captured by the fibers of uterine tube epithelium. In tube it encounter with sperm that have penetrated it during intercourse. 
Fertilized, the egg is sent to the uterine cavity, where it is fixed.

If there are adhesions, scars or fluid in the lumen of the fallopian tube, then male and female germ cells do not contact. The result is an inability to get pregnant.

The problem also arises when adhesions are not inside the tube, but outside, in the abdominal cavity and in the small pelvis. Tubes are deformed, bent, which again violates their normal flow.

The causes of tubal infertility are following:

•    surgical interventions in the pelvic organs, including artificial termination of pregnancy;
•    gastrointestinal tract operations (for example, regarding the removal of the appendix);
•    genital infections
•    endometriosis, fibromyoma, uterine fibroids;
•    chronic inflammatory conditions of other organs (intestines, lungs, throat, bronchi), causing inflammation in the uterus, tubes and ovaries;
•    defects in the production of hormones and metabolism.

Chronic inflammation, neoplasms, injuries - these factors lead to the nascency of adhesions and constrictions from the connective tissue in the lumen of the fallopian tubes. As a result, the patency of the organs is disturbed, their walls are stretched, and the epithelium becomes unable to move the egg on its way into the uterus.

HOW TO REVEAL TUBAL INFERTILITY

You need to visit a reproductologist if you cannot become pregnant (over the age of 35 years - within six months)during a year of regular sexual activity without contraception. Both partners need to be examined, because half of the cases of infertility are male. Medical Plaza provides a full range of diagnostic services to identify the causes of decreased fertility in men and women.

If the reproductologist has a suspicion that the infertility is tubal, the woman will need to undergo an in-depth diagnosis.

Diagnosis of tubal infertility:

•     Hysterosalpingography. The uterine cavity is filled with a radiopaque substance through the cervix and a picture is taken. If the fallopian tubes are not completely displayed on an x-ray (they should look like thin lines), the cause of infertility is their obstruction.
•     Laparoscopy. After a few small punctures, instruments, optics and lighting are introduced into the pelvic cavity. The doctor evaluates the condition of the tubes and can immediately restore their patency during the operation (if the problem is simple).
•     Echohysterosalpingography. A study is similar to a diagnosis with contrast, but physiological saline is injected into the uterus and tube patency is observed using ultrasound.

Medical Plaza provides necessary diagnostic procedures.

THERAPEUTIC METHODS

Treatment of tubal infertility can be conservative and surgical. Conservative therapy includes such methods:

•     treatment with anti-inflammatory drugs to relieve inflammation and restore mucous membranes;
•     physiotherapy;
•     hydrotubation (the introduction into the uterine cavity of solution medications under pressure);
•     perturbation (restoration of patency of the fallopian tubes by "blowing" air).

Conservative treatment gives lower efficacy than surgical one. Therefore, in the question of how to treat tubal infertility, doctors are more likely to lean towards surgical techniques. Surgical intervention can be carried out in two ways - open and laparoscopic.

•     Open method. The doctor dissects the front wall of the abdomen with a scalpel and gains access to the uterus and fallopian tubes. A traumatic method requiring a long stay of a woman in clinic.
•     Laparoscopy. It is carried out using small tools that are inserted into the body through punctures. Laparoscopy in the treatment of tubal infertility is preferable, since relapses and complications less often occur. A woman recovers faster after surgery - in a few days you can live an ordinary life.

Many patients ask if tubal infertility and IVF are compatible. Reproductologists and gynecologists always resolve this issue individually. If there is fluid in the lumen of the fallopian tube (sactosalpinx), then an operation to remove these formations or the tubes itself is necessary. Liquid tumors are dangerous because they are prone to inflammatory infectious processes, interfere with the attachment and normal development of the embryo in the case of in vitro fertilization.

EXPECTED RESPONSE TO TREATMENT

Whether tubal infertility can be treated depends on the specific situation. With slight damage to organs, single adhesions treatment gives good results, and the couple is able to conceive a child after a rehabilitation course. 

If there are numerous adhesions and fluid formations in the fallopian tubes, the tubes are enlarged, and their walls are thin, then the prediction whether tube infertility can be cured is not very favorable. Sometimes removal of the fallopian tubes is required. In such cases, the IVF is recommended to patient.

WHAT IS THE DANGER

Sometimes obstruction of the tubes is partial, and problem can concern only one of the organs. In this case, a woman may become pregnant. But with partial obstruction, the risk of an ectopic pregnancy increases significantly, when a fertilized egg fixes in the lumen of tube, failing to get into uterus. Ectopic pregnancy requires urgent surgical intervention to save a woman's life. Therefore, the tubular factor of infertility must be eliminated.

HOW TO PREVENT UTERINE TUBE OBSTRUCTION

Female infertility of tubal origin can be prevented if inflammatory diseases of the reproductive organs and other systems are timely treated, strictly following the doctor's recommendations. In the case of operations in the abdomen or pelvis, a woman needs to undergo a full course of rehabilitation, physiotherapy exercises, take prescribed medications and physiotherapy. The same applies to the injuries in the abdomen. Then the risk of adhesions and scars is significantly reduced.

WHY IT IS WORTH CONTACTING MEDICAL PLAZA

Our advantages in the treatment of infertility have already been appreciated by hundreds of happy couples who managed to conceive a long-awaited child. Medical Center Medical Plaza has vast experience in the field of reproductive technologies and offers its patients a complete diagnosis of men and women in the direction of a reproductive specialist.

Our medical center has all the necessary equipment for ICSI and PIXI procedures (insertion of sperm into the egg in laboratory conditions), auxiliary hatching of embryos and the implementation of a full IVF cycle. Our professional embryologists evaluate the morphological characteristics of embryos in order to determine the highest potential for implantation into the uterine wall.

Medical Plaza works in the field of oncofertility. We offer sperm and egg freezing to people with cancer. After undergoing a therapeutic course that can damage the germ cells, our clients will be able to give birth to healthy children.

We are proud that we helped more than five hundred babies to be born. Children were born in happy families not only in Ukraine, but also in Israel, USA, Russian Federation, Portugal and other countries all over the world.