Blocked fallopian tubes
After ovulation, if the route for the eggs to the uterus is blocked, a pregnancy cannot occur. Tubes that are twisted and thin normally have muscles in their walls that are too thin and cannot produce the pumping movement necessary to push the egg into the womb. Narrow and weak tubes are congenital. Agglutinations generate from inflammations on the ovaries and tubes - chlamydia and gonorrhoea being the main causes. An inflammation in the ovaries and fallopian tubes, the appendices of the uterus, is called adnexitis.
The impact of adnexitis on a woman is long term and can have an impact on both her private and professional life, including the risk of permanent infertility. Adnexitis predominantly results from a vaginal inflammation and, when other factors are involved, can allow organisms (mostly bacteria) to ascend to the uterus and fallopian tubes. The disease begins suddenly with strong abdominal pain,fever and other distinctive symptoms. Quick, timely, conservative treatment can avoid acute complications and a transition to the chronic stages of the disease.
Open functional tubes are an essential precondition for the occurrence of natural pregnancy. If it can be proved that the tubes are closed or unusable in the long-term, then patients can profit from the IVF fund which will pay 70 % of the treatment and medication costs of an IVF or an ICSI treatment (provided a previous ligation of the tubes is NOT given!).
A corrective surgery of blocked tubes is not an established treatment and requires hours of microsurgery. Pregnancy rates after corrective surgery on both fallopian tubes and spermatic ducts are extremely low. On the other hand, "classic IVF treatment" is routine nowadays and has a pregnancy rate of approximately 50 % per attempt. The first therapy for cases of closed fallopian tubes is therefore IVF, and in the case of closed spermatic ducts the first treatment is TESE/ICSI.
Chlamydia – the undetected infection
Here’s the good news first: Chlamydia infections are treatable. There is no reason for panic! Unfortunately, most infected women don't know that they are infected.
Approximately 100,000 people are infected with chlamydia in Austria alone. One in 30 adults and one in 16 teenagers are infected. Chlamydia proliferates very slowly and initially shows no symptoms. It can also hide for years within the body before developing.
If the body defences are weakened through illness or stress, the infection can develop. Typical signs in the woman are frequent abdominal pains with no visible causes and in-between bleedings and discharge. The infection can also lead to serious disease and permanent health damage. For example, in about 40 % of infected women the bacterium reaches the fallopian tubes and 1 in 5 of these women is subsequently unable to naturally have children.
Examination of fallopian tubes:
Hysteroscopy and diagnostic laparoscopy are the modern methods used to clarify organic causes in patients who cannot conceive naturally. The laparoscopy offers the ability to examine the whole abdominal area, fallopian tubes, ovaries and outer uterus. It also allows a smear to be taken from the fallopian tubes in order to eliminate infections caused by bacteria or chlamydia and to thoroughly check if the tubes are open. Performing this under anaesthetic allows us to exclude and/or confirm a range of possible causes for infertility in one session, and very often treat them at the same time. This includes for example myomas, endometriosis, agglutinations of the fallopian tubes and pathological changes of the ovaries. In order to examine the uterus cavity, the diagnostic laparoscopy is generally combined with a uterus laparoscopy.
Fallopian tubes X-ray (hysterosalpingography):
After the exclusion of all functional disorders, the patency of the tubes (whether the tube is open or not) can be checked using a radiography of the tubes. In this examination a contrast agent is injected into the uterus (without anaesthetic) and the flow of this agent is then documented in a series of X-ray pictures. This examination is usually performed after the menstruation
The hysterosalpingo contrast agent ultrasonography checks the patency of the tubes using ultrasound and an echogenic contrast agent.A special catheter and a fluid are used. With this simple procedure it is possible to make an ambulant check in the fallopian tubes without anaesthetic or any pain at the KinderWunschKlinik.