Treatment
Traditionally Fallopian tubal surgery (tuboplasty) was used to restore patency to the tubes and thus possibly normal function. However, in most situations today, in vitro fertilization is used to overcome tubal infertility as it is more cost-effective, less invasive, and results are immediate. With IVF, after stimulation of ovarian follicles, egg cells are removed via a sonographic directed vaginal puncture into the ovary, these eggs are fertiized outside the body, and the resultant embryo placed transcervically into the uterus; - the tubes are bypassed in this process.
Different types of tuboplasty have been developed and can be applied by laparoscopy or laparotomy. They include lysis of adhesions, fimbrioplasty (repairing the fimbriated end of the tubes), salpinostomy (creating an opening for the tube), resection and reananstomosis (removing a piece of blocked tube and reuniting the remaining patent parts of the tube), and tubal reimplantation (reconnecting the tube to the uterus). Further, using fluoroscopy or hysteroscopy proximal tubal occlusion can be overcome by transcervical catheter recanalization or falloposcopy.
Results of tubal surgery are inversely related to damage that exists prior to surgery. Development of adhesions remains a problem. Patients with operated tubes are at increased risk for ectopic pregnancy.
Surgical repair of fallopian tubes that have been occluded by a sterilization procedure generally have good success rates provided enough healthy tubal tissue is present for the surgeon to perform a tubal reversal.
While IVF therapy has largely replaced tubal surgery in the treatment of infertility, the presence of hydrosalpinx is a detriment to IVF success. It has been recommended that prior to IVF, laparoscopic surgery should be done to either block or remove hydrosalpinges.
Read more about this topic: Fallopian Tube Obstruction
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