The fallopian tubes connect the ovaries (where eggs are released) to the uterus (where the fertilized egg develops into a fetus). Generally, sperm swim up from the vagina, through the cervix and uterus, and into the fallopian tubes where the sperm can fertilize the egg. If a woman is having difficulty achieving pregnancy, blocked fallopian tubes may be the cause. If this is the case, tubal surgery has the potential to correct the blockage.
Infections, abdominal surgery, and other diseases like endometriosis can cause damage to the tubes, or adhesions or scar tissue to build up and block the tube. Chlamydia and gonorrhea, two common sexually transmitted infections, are the most common infections that cause tubal blockage. Tuberculosis (which is uncommon in North America) can also cause tubal disease and damage. In addition, infection caused by the appendix rupturing also causes blocked tubes. The surgeon will try to cut the scars between the fallopian tubes and ovaries. If one or both tubes are completely blocked, the surgeon can attempt to open the tube.
If the fallopian tubes are blocked due to tubal ligation – a procedure that purposely blocks the tubes by cutting or tying them as a form of birth control – tubal ligation reversal may be able to reverse the affects.
Before the surgery, the doctor will determine what type of surgery is needed by checking the fallopian tubes with a hysterosalpingogram. In order to assess the tubes, a special liquid that is visible to x-rays is put into the womb to see if it can travel through the tubes. If it cannot, a blockage probably exists. If mild or moderate, this can be fixed through laparoscopy or laparotomy. If the damage is severe, however, repair has a low likelihood for success and alternative treatments such as IVF may be necessary.
|If you Have||Your chance of getting pregnant after surgery is…|
|Very few adhesions between the tubes and ovaries||Much better|
|A lot of thick adhesions between the tubes and ovaries||Not good, possibly requiring IVF|
|A blocked tube that is otherwise healthy||About 20 percent to 30 percent|
|A blocked tube that is filled with fluid (called hydrosalpinx)||Not good – and the tubes will probably need to be removed or surgically blocked to increases success chances with IVF|
Risks of Tubal Surgery
The possibility of developing an ectopic pregnancy – when the fertilized egg implants in the fallopian tube rather than the uterus – is the biggest risk of tubal surgery. The tube is too small to support a developing baby, and the tube will burst if the pregnancy is carried too long. If the pregnancy is not terminated, it can cause internal bleeding and may become an emergency, life-threatening situation in rare cases.
As soon as a woman who has had tubal surgery suspects she is pregnant or misses a period, she should notify her doctor immediately to be monitored. Common symptoms of ectopic pregnancy are lower abdominal pain and vaginal bleeding.
Other risks of tubal surgery include the possibility of bleeding, damage to other organs, infection or a reaction to the anesthesia.