Challenges Of Fallopian Tubes, Pelvis Abnormalities
The fallopian tube may be blocked or damaged, preventing the sperm from reaching the egg or preventing the fertilized egg (zygote) from moving from the ovary to the uterus for implantation. Abnormalities in the pelvis can prevent the egg from attaching to (implanting in) the lining of the uterus and can block the fallopian tubes.
•To identify the problem, doctors may use X-rays taken after a radiopaque contrast agent is injected through the cervix, do ultrasonography after a salt solution is injected inside the uterus (sonohysterography), or view the organs through a viewing tube (laparoscope) inserted through an incision just below the navel.
•The fallopian tubes can sometimes be repaired, but in vitro fertilization is usually recommended.
Causes
Fallopian tube problems result from conditions that block or damage the tube, including the following:
•Pelvic infections (such as pelvic inflammatory disease)
•Use of an intrauterine device if it causes a pelvic infection (which is rare)
•A ruptured appendix
•Surgery in the pelvis or lower abdomen
•Inflammation that damages the uterus and fallopian tubes (such as tuberculosis)
•A mislocated (ectopic) pregnancy in the fallopian tubes
Bacteria, such as those that can cause pelvic inflammatory disease, can enter the vagina during sexual intercourse with a partner who has a sexually transmitted disease. The bacteria can spread from the vagina to infect the cervix. They may then spread upward, to the uterus and sometimes the fallopian tubes. Some bacteria, such as chlamydia, can infect the fallopian tubes without causing any symptoms. These infections may permanently damage the fallopian tubes, uterus, and surrounding tissue. Scar tissue may form and block the fallopian tubes.
Abnormalities in the pelvis can block the tubes or prevent the egg from implanting in the uterus. They include the following:
•Birth defects of the uterus and fallopian tubes
•Endometriosis
•Fibroids in the uterus
•Bands of scar tissue (adhesions) that form between normally unconnected structures in the uterus or pelvis
Adhesions in the uterus are typically caused by infections or injuries during surgery, most commonly dilation and curettage (D&C). This disorder is called Asherman syndrome.
Diagnosis
•Hysterosalpingography
•Sometimes sonohysterography, laparoscopy, or hysteroscopy
•Sometimes a blood test to check for antibodies to chlamydiae
Procedures are done to determine whether the fallopian tubes are blocked. They include hysterosalpingography, sonohysterography, laparoscopy, and hysteroscopy. During laparoscopy and hysteroscopy, diagnosis and treatment are often performed simultaneously.