Tubal Disease

When eggs mature, a surge of luteinizing hormone (LH) initiates ovulation. It causes the ovaries to release the eggs, which then travel through the fallopian tubes where fertilization occurs and then to the uterus where implantation occurs.

Women with tubal disease or abnormalities often have a blockage or damage to their fallopian tubes, which impedes the progress of the egg or embryo.

Some women who’ve had their fallopian tubes tied as a means of birth control wish to reverse the surgery. Although tubal ligation reversal can be done with relative success, there is no guarantee that the reversed surgery will restore fertility.

In vitro fertilization (IVF) is a common treatment option for women with tubal disease. Eggs are retrieved from the follicles and do not have to make the passage through the tubes. In IVF, the eggs are fertilized in vitro (outside the body), incubated, and the embryos then transferred to the uterus.

Although IVF success rates are higher than tubal reconstruction surgery, some women choose to reconstruct their fallopian tubes to be able to attempt pregnancy naturally. Tubal ligation reversal success rates are comparable to IVF.

What causes tubal disease?

The most common cause is Endometriosis. That’s when the endometrial tissue attaches to, and sometimes penetrates, the fallopian tubes. Severe pelvic infections and scars from pelvic surgery can also damage the fallopian tubes as well as the ovaries and uterus.

Can PCRM do tube-tying reversals?

Yes. The physicians at PCRM have extensive experience and expertise in tubal reversal surgery. However, the success of tubal reversal surgery depends upon how and where the tubes were cut. Tubal ligation (getting your tubes tied) should always be considered a permanent means of birth control.

My HSG X-ray shows that I have damaged fallopian tubes. What are my best options for getting pregnant?

Approximately 25% of women with fertility difficulties will have some form of tubal disease. If it is very mild, it may be corrected with minimally invasive laparoscopic surgery. If the damage is moderate to severe, typically the tubes cannot be repaired and in vitro fertilization (IVF) is your best option for pregnancy.

My HSG X-ray shows that my fallopian tubes are swollen. What does this mean?

Swollen fallopian tubes are called hydrosalpinges. This indicates that the tubes have been severely damaged, and are likely not functional. This can be confirmed by laparoscopy. If they are truly swollen, the best treatment is their removal during laparoscopy followed by IVF. The fluid in the tubes is toxic to both embryos and sperm, and for this reason, requires removal once the decision to proceed with IVF is made.

Back to Resources