What to do if both sides of the fallopian tubes are blocked

A baby is particularly important to a family. We all know that fallopian tube blockage makes it extremely difficult for a woman to conceive a baby, because fallopian tube blockage can lead to abnormal ovulation. Fallopian tube blockage is also the most direct and fundamental cause of infertility. Therefore, such a problem must be treated in time. Let’s learn about what to do if the fallopian tubes on both sides are blocked.

Fallopian tube blockage is the main cause of female infertility, accounting for 25% to 35% of female infertility, and the main cause of fallopian tube damage is pelvic inflammatory disease (PID). The incidence of secondary fallopian tube obstruction is directly related to the incidence of PID. Reproductive capacity after fallopian tube reconstruction depends on the site and extent of fallopian tube damage. Women with extensive fallopian tube damage have a lower chance of becoming pregnant, and IVF can improve their pregnancy rates.

What to do if both sides of the fallopian tubes are blocked

1. Treatment of proximal fallopian tube obstruction

Proximal tubal obstruction accounts for 10% to 25% of female tubal diseases. The recanalization of proximal tubal obstruction can be achieved by hysteroscopic COOK guidewire recanalization or partial tubal resection and re-anastomosis. Hysteroscopic guidewire recanalization is a procedure in which a COOK guidewire is inserted into the interstitial part of the fallopian tube under hysteroscopy to perform tubal fluid perfusion. The interstitial and isthmus parts of the fallopian tube are recanalized through the separation and dilation of the guidewire sheath and the impact of the fluid. The operation is simple but expensive. About 85% of proximal tubal obstructions can be resolved by proximal guidewire dredging, but the reported postoperative pregnancy rates vary greatly, ranging from 12% to 39%, and the incidence of ectopic pregnancy is 2% to 9%. If the patient cannot undergo guidewire recanalization, the obstruction site can be found and partial fallopian tube resection and anastomosis can be performed.

2. Treatment of mid-fallopian tube obstruction

Mid-fallopian tube lesions refer to obstruction or missing changes in the middle part of the fallopian tube. The causes of the disease are tubal pregnancy and tubal sterilization. Fallopian tube anastomosis is a commonly used surgical method for mid-fallopian tube obstruction. It is a procedure that removes the blocked part of the fallopian tube under laparoscopy and anastomoses the two ends of the fallopian tube. Foreign reports show that the postoperative pregnancy rate of fallopian tube anastomosis is 74% to 81%, and the incidence of ectopic pregnancy is 4.8%.

3. Treatment of distal fallopian tube obstruction

Distal fallopian tube lesions account for 85% of tubal infertility. The causes of distal fallopian tube obstruction are pelvic inflammatory disease and peritonitis and previous pelvic and abdominal surgery.

(1) Salpingostomy is one of the commonly used methods to solve infertility caused by distal fallopian tube obstruction. However, since obstructed fallopian tubes are often accompanied by severe destruction of the ciliary tissue in the fallopian tube cavity and damage to the peristaltic ability of the fallopian tube muscle layer, the postoperative pregnancy rate is only about 30%. In addition to the operating skills, the factors that determine the success of the operation are also related to the degree of damage to the fallopian tube. In the case of external adhesions of the fallopian tube caused by endometriosis, appendicitis, etc., the ciliated cells and mucosal folds of the fallopian tube itself are not damaged, and the postoperative pregnancy rate is relatively high. On the contrary, fallopian tube obstruction caused by infection with chlamydia, gonococci or tuberculosis often causes serious damage to the fallopian tube endometrium, and the effect of salpingostomy is relatively poor.

(2) This part of the fallopian tube fimbriaplasty refers to the disintegration or dilation of the narrowed fallopian tubes that have not yet completely closed and formed hydrops due to adhesions at the ends of the fallopian tube fimbria. Relatively speaking, the damage to the fallopian tubes in these patients is significantly milder than that in those with complete atresia or hydrops. Therefore, the effect of the surgery is more significant. If there is no obvious adhesion around the fallopian tube and ovary, and the fimbria mucosa is good after separation, more than 80% of patients can achieve intrauterine pregnancy after surgery. However, if the fallopian tube forms dense adhesions with the ovary or surrounding tissues and the wound is huge after separation, the prognosis of the operation will be poor, the natural conception rate after surgery will decrease, and the risk of ectopic pregnancy will increase. When both distal and proximal tubal obstruction exist, the surgical success rate is 5% or less.

(3) Studies on salpingectomy have shown that hydrosalpinx has a harmful effect on in vitro fertilization-embryo transfer. The possible mechanism of action is that toxins in the hydrosalpinx can flow back into the uterine cavity and damage the transplanted embryo.

(4) Treatment of adhesions around the adnexa: Tubal-ovarian adhesion lysis: refers to the decomposition of adhesions between the ovaries and fallopian tubes and around all adnexa. Adhesions around the fallopian tubes interfere with the fallopian tubes' egg-collecting and gamete-transporting functions. If adhesions form around the ovaries, they will also inhibit the discharge of eggs. Tubo-ovarian adhesiolysis increases the cumulative pregnancy rate threefold. If the adhesions are mild, the pregnancy rate after surgery is good (24 months, 60%), but if the adhesions are dense, the outcome is poor and these patients are best treated with IVF.

With the increasing number of infertile people, such problems must be checked and treated in time, which often makes many people particularly worried. Fallopian tube blockage is the direct cause of infertility. The above is an introduction to what to do if the fallopian tubes on both sides are blocked. If such symptoms occur, timely treatment must be sought. Don't always ignore your own health problems.