Treatment of blocked fallopian tubes
Tubal infertility is diagnosed in between 15% and 50% of couples presenting with subfertility. The diagnoses can be made with one of several techniques, the most common investigation being X-ray hysterosalpingography. Other investigations include ultrasound contrast hysterosalpingography (or hysterosalpingo-contrast sonography, HyCoSy) and laparoscopy (keyhole surgery.)The fallopian tubes are 6 to 10 cm long and situated at the top end of the uterus, one on each side. The ovaries are normally situated close to the external opening of the fallopian tubes, also known as the fimbriae. When an egg is released it can be picked up by the fimbriae. Fertilisation of the egg occurs inside the tube and only (after 5 to 7 days) will the embryo implant inside the uterine cavity. There are many causes for tubal dysfunction, but the main condition is chronic pelvic infection. Chlamydia is a low grade, ongoing infection which can cause tubal blockage or scarring of the tubal tissue. The infection simmers on inside the pelvis over many years without necessary causing any symptoms to the woman. It is only diagnosed when the patient presents for another associated gynaecological problem such as infertility. There are however many other infections that may also hinder tubal function and cause blockage. It is important to also remember that, even though tubes may appear open with radiological or surgical investigations, these tests unfortunately reveal very little information on how well the tuba actually functions. Therefore, patency of fallopian tubes does not automatically confirm normality. This explains why patients may have tubal pregnancies (ectopic pregnancies) where the sperm moves through the patent tube, fertilises the egg inside the tubal but due to poor tubal function, the embryo cannot migrate into the uterine cavity.
