Dr.Anita Mani
***Infertility& Surrogacy Specialist at Gift IVF Centre
Blocked or damaged fallopian tubes can stop pregnancy
Blocked or damaged fallopian tubes can be a hindrance in conception.To understand tubal problems , basic fertilisation should be understood .During sexual intercourse sperms are deposited in the vagina.The sperms swim up , passing through the cervix to reach the tubes where the egg is located .During ovulation, egg is released from the ovary.By the vacuum force created by tubal contractions, along with waves created by structures called cilia in the tubes this egg reaches the tube.The actual fertilisation happens inside the tubes, when many sperms attaches to egg, but one sperm penetrates the thick cover of the egg and enter inside .The embryo which is formed as a result of fertilisation, starts dividing into multiple cells and is moved towards the uterus.This movement is again facilitated by tubal contractions.Hence, it is very important for the tubes to have normal anatomy and normal function , which can be altered even with presence of small fibrosis or adhesion .
If the fallopian tubes are blocked , sperm will not reach the egg .So fertilisation and pregnancy will not happen.The defective tube may stop embryo from moving to the uterus and it will remain in the tube leading to tubal pregnancy ( ectopic pregnancy).This can cause complications like rupture of tube, which sometimes results in maternal death.
The causes for tubal blocks are pelvic infections , endometriosis, adhesions involving tubes, previously performed surgeries in abdomen or pelvis , fibroids near tubes and in some cases pelvic tuberculosis.
Laparoscopic Surgery can be done to try and correct the tubes, but has poor success, as the fibrosis formed can cause problems to reoccur.The type of procedure depends on the location and extent of damage.Tubal reanastamosis can be used to correct the problem in case of sterilisation , but again has only 60% success , and there is increased risk of ectopic pregnancy.The chances for conception differ, depending on the location and severity of the blockage and the scar tissue after surgery.Medical treatments for endometriosis have very little role , in case of tubal pathology which often just prolongs the treatment, which will decrease the chance of success .
IVF is the best choice of treatment for any tubal problem , as the tubes are not involved in the procedure of IVF because the fertilisation happens in the lab.If surgery fails or if the pelvis is badly damaged beyond repair leading to multiple IVF failure, surrogacy is the best alternative.
