6 Steps to getting pregnant with blocked fallopian tubes | Clogged fallopian tube: causes, symptoms, treatment


Steps to getting pregnant with blocked fallopian tubes

Often discovered during a fertility check-up, a blocked fallopian tube usually does not cause symptoms. What are the causes ? The consequences for a pregnancy? The treatment ? Explanations by Dr Mauricette Sebaoun, gynecologist member of the National Federation of Colleges of Medical Gynecology.

Definition: what are the fallopian tubes?
A woman has two fallopian tubes , located on either side of the uterus . They allow the movement of the egg released by the ovary to the uterus, when it has been fertilized by a spermatozoon. The fertilized egg will make its way to the uterine cavity and nest one week after fertilization. The fallopian tubes therefore have the main role of passing the egg into the

What causes a blocked fallopian tube?

There are three main causes of tubal obstruction:

► Genital infections: in the majority of cases, a tube is blocked following a genital infection leading to salpingitis (tube infection). " Most of the time, these infections are linked to a sexually transmitted disease such as chlamydia or gonococcus . The infection can also be linked to the IUD present in the uterine cavity which becomes infected and infects the fallopian tubes" , specifies Dr. Mauricette Sebaun. 

► Endometriosis : pieces of uterine lining can block the fallopian tubes, preventing the progress of sperm to the egg and thus making fertilization impossible.  

► Adhesions: the tubes may have been infected following surgery in the abdomen, for example appendicitis which would have been complicated by peritonitis .

What are the symptoms ?

Most of the time, tubal blockage causes no symptoms. It is often discovered by chance , during a fertility check-up or during a consultation for an ectopic pregnancy . Nevertheless, pelvic pain may occur at the time of acute infection. " When the gynecologist looks for a chlamydia infection , he always checks to see if the infection has not gone up into the tubes, since salpingitis is the main cause of tubal sterility ", explains the gynecologist. 

What consequences?

" The major consequence is tubal infertility linked to the fallopian tubes . As the fallopian tubes are blocked, the passage of spermatozoa into the uterine cavity is impossible . The meeting with the egg cannot therefore take place. In some cases, fertilization is effective, but the egg cannot implant in the uterus, the woman then risks an ectopic pregnancy . On the other hand, the fact that a fallopian tube is blocked does not have any incidence on the menstruations ", indicates the specialist. 

How is the diagnosis made?

The diagnosis is often made during the fertility check-up, and more precisely thanks to the hysterosalpingography (x-ray of the tubes) which aims to check the permeability of the tubes and which attests to the fact that the spermatozoa can meet an ovum. The diagnosis can also be made by ultrasound, scanner or MRI if the woman has hydrosalpinx, which means that the fallopian tube has filled with fluid (serosity) and is dilated. At this stage, it is called chronic tubal infection disease .

What are the treatments ?

Treatment depends on the cause of the obstruction. " In the event of endometriosis, the management is based on drug or surgical treatment in order to remove the pieces of uterine lining which obstruct the fallopian tube ", informs our interlocutor. A surgical procedure called tubal plasty may also be considered. It consists of releasing the adhesions under laparoscopy. " Anyway, a fallopian tube that has been blocked by infection shows irreversible damage.cilia located inside the fallopian tube and whose role is to mobilize the egg towards the fallopian tube at the time of fertilization. If the eyelashes have been destroyed, there may be fertilization but the egg will remain stuck in the fallopian tube and give rise to an ectopic pregnancy ,” she continues.

Blocked fallopian tube and desire for pregnancy: what impact?

If a fallopian tube is very damaged, it is removed before doing in vitro fertilization because the presence of inflammation reduces the chances of pregnancy in in vitro fertilization
Faced with altered fallopian tubes, couples are offered to go immediately to in vitro fertilization (IVF) , except in the case of hydrosalpinx (the fallopian tube contains pus or serum). " If a fallopian tube is very damaged, it is removed before doing in vitro fertilization because the presence of inflammation reduces the chances of pregnancy in in vitro fertilization. If the fallopian tube is very little damaged and it presents a whole small adhesion, pressurizing with hysterosapingography fluid may be enough to unclog it, and often pregnancy occurs within a month of the examination ,” observes Dr Mauricette Sebaoun.

What prevention?

To prevent infection and obstruction of the tubes, it is essential to protect yourself against sexually transmitted infections , particularly chlamydia infection , by wearing a condom. " Let us specify that the risk of infection is proportional to the number of partners: the more one exposes oneself, the more one risks contracting an STI and ending up with a blocked fallopian tube" , insists the gynecologist.

Tubal surgery

Depending on the position of the damage or blockage - and the severity of the damage - it may be possible to repair a fallopian tube. Fortunately, there is an alternative to "open surgery": minimally invasive surgery or laparoscopy.

Medfem Fertility Clinic specialists are experts and leaders in minimally invasive surgery. It is one of the first institutions in South Africa to have developed a complete operating room with all the necessary equipment to perform minimally invasive surgery. The specialists at Medfem Fertility Clinic have all undergone extensive training abroad and teach endoscopic surgery continuously to visiting gynecologists.

Minimally invasive surgery or laparoscopy involves looking directly into your abdomen and pelvis using a small camera placed through an incision in your umbilicus. This allows a specialist to assess and possibly treat gynecological issues such as scar tissue, adhesions, and endometriosis.

For this operation you will need general anesthesia (you will be asleep), but in most cases you will go home the same day. Once the incision has been made (usually near the navel), the laparoscope is inserted into the abdominal cavity. Carbon dioxide or nitrous oxide gas is then introduced into the cavity to separate the abdominal wall from the underlying organs. This facilitates the examination of internal organs. Between one and three more incisions are made to allow access to other surgical instruments, such as a laser. Once the diagnosis is established or the problem eliminated (or both), the instruments are removed, the gas allowed to escape and the stitched incisions are closed. The stitches may need to be removed at a later stage,

Most women experience bloating, abdominal pain, and/or back and shoulder pain within 24-48 hours after surgery. This is normal and is related to the gas used to distend your abdomen during surgery. This pain should not be severe and should gradually improve over 24-48 hours. You may also experience abdominal bloating, nausea, abdominal cramps, or constipation.

Most patients are able to resume normal activities within a few days to a week. We recommend that you refrain from strenuous physical activity for about a week. After a pelvic laparoscopy, we recommend that you use sanitary napkins instead of tampons to treat any vaginal bleeding or discharge.

It is absolutely essential that this advanced surgery is performed by a qualified and knowledgeable fertility specialist.

In Vitro Fertilization (IVF) Treatment

In vitro fertilization (IVF) treatment was originally developed for women with damaged or missing fallopian tubes in 1983, and since then more than 5 million babies have been born worldwide as a result of IVF treatment, with success rates comparable to – and even higher than – those of nature.

In simple terms, IVF treatment is a process of medically assisted reproduction in which the egg and sperm are fertilized outside the body to form an embryo, which is then transferred to the uterus to be implanted there and become pregnant.

However, IVF treatment is not an isolated event, but rather a series of procedures completed in five steps to complete a treatment cycle.

IVF treatments begin with hormone therapy to stimulate the development of several follicles in the ovary. Under ultrasound guidance, these are then pierced with a specialist needle to retrieve the eggs, which are then fertilized in a petri dish ('in vitro' which literally means 'in glass') to create multiple embryos . After three to five days in an incubator, one or two of these embryos are transferred through the vagina to the uterus, where implantation takes place and pregnancy begins. The whole process, from the start of ovarian stimulation to the embryo transfer stage, usually takes just under three weeks.

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