The causes of female infertility can be listed as follows: uterine disorders, uterine anomalies, ovulation disorders, hormonal imbalances, and partial or complete occlusion of the tubes. Women ovulate once a month during their ovulation period, that is, the egg is released from the ovary.
After that, one of the fallopian tubes, which have two on the right and left, catches this egg with the fringes in its mouth, and if it meets the sperm, fertilization and therefore pregnancy may occur. To achieve pregnancy naturally, the woman must first be able to ovulate in a healthy way, and then the tubes must be working with full function. Because the most common cause of female infertility is obstructed tubes.
How is it possible to diagnose a tubal defect?
First, ultrasound and sperm analysis are performed for couples who apply to the doctor with the complaint of not being able to conceive naturally. In cases where these give a positive result, the uterus film is taken, and the condition of the canals is evaluated. In this sense, it is important to inquire about the woman’s past pregnancies, infertility history, abortion history, cesarean section history, presence of appendix surgery, and intra-abdominal operations. If one or both tubes are found to be closed/occluded in the uterine film data, a clear diagnosis is made with the Laparoscopic method (closed surgery). The probability of a woman to conceive naturally is very low if one of the tubes is closed and the other is open according to the result of laparoscopy. However, when one of the tubes is open, pregnancy can be achieved by insemination. In cases where two of the tubes are blocked, the tubes can be opened with the laparoscopic method and pregnancy can be achieved. However, if the age of the woman is advanced, pregnancy can be achieved with IVF treatment in order not to waste more time.
What are the causes of obstructed tubes?
Pelvic (intra-abdominal) infections
Infections that occur in the woman’s intra-abdominal organs such as ovaries, tubes, and uterus are often not felt, they may even turn into abscesses in the future and cause obstruction in the tubes. Pelvic infections can both disrupt the relationship between the tubes and the ovaries and cause fluid to accumulate in the tubes, resulting in dysfunction in the tubes. Infertility can occur if both tubes are obstructed due to infection.
Myoma surgery, ovarian cyst removal, intestinal operations can cause obstruction in the tubes. All kinds of factors that negatively affect the intra-abdominal tissue and organs in the abdomen can damage the tubes.
Endometriosis (chocolate cyst)
The formation and settlement of the inner tissue of the uterus in areas outside the uterus is called Endometriosis. When endometriosis occurs in an area close to the tubes, it can damage the functions of the tube and disrupt the coordinated relationship between the ovaries and tubes.
How are these tubes treated?
The tubes are located between the uterus and ovaries under normal conditions. If the tubes are obstructed, it is important for the treatment whether there is an obstruction near the uterus or the ovaries. If there is an obstruction in the tubes near the uterus, these obstructions can be opened with microsurgery, and approximately 60-70% success is achieved. Because in microsurgery, obstructions are removed by applying cannulation to the tubes. If it is observed during the examinations that the tubes are filled with liquid, the tubes are completely removed by laparoscopy or open surgery, considering that the liquid will damage the embryo. Treatment of tube obstructions with surgical operations does not provide 100% success, but it increases the chance of pregnancy naturally. However, it should not be forgotten that assisted reproductive treatment methods are effective in cases of tube obstruction.
In addition to all these, it is useful to underline that; In tube problems other than the problem of fluid accumulation in the tube, which will require the removal of tubes, treatment options should be sought.