Unblocking Happiness: A Successfully Treated Case of Bilateral Fallopian Tube Blockage
Mr and Mrs S visited Dr Pallavi Chennamaraji at Nova IVF, Tambaram, in Chennai. The couple had been married for six years and visited Dr Pallavi with complaints of infertility. The couple was concerned that they could not conceive despite being a normal couple with no medical conditions.
After taking a thorough medical history, Dr Pallavi advised Mr and Mrs S to undergo a fertility assessment. The tests were aimed to evaluate Mrs S’s capability to ovulate, her tubal patency, and health of her uterus, and Mr S’s sperm quality, quantity, and motility. Mrs S was 29-years-old, with regular cycles. The couple did not face any difficulties having sex. Mrs S had a history of whitish vaginal discharge three years back and was treated using vaginal tablets.
To evaluate Mrs S’s uterus and fallopian tubes better, Dr Pallavi advised an HSG (Hysterosalpingography) and a hysteroscopy.
What is Hysterosalpingography?
HSG or hysterosalpingography is an x-ray examination that allows better visualisation of a woman’s fallopian tubes and detects blockages. A radiocontrast dye is injected into the woman’s uterus via her vagina and cervix to perform this test. A series of x-rays are then performed to see the uterus and the fallopian tubes. If a fallopian tube is open, the injected dye fills it and then spills into the pelvic cavity. Any abnormal shape of the uterus is outlined in this test.
What Causes Blockage of the Fallopian Tubes?
Around 25-35% of subfertility in women occurs due to the tubal factor. It is when the fallopian tubes are blocked (either completely or partially; at the near end or far end).
A normal fallopian tube is essential to achieve a successful pregnancy. The sperms meet the egg in the fallopian tubes, and once fertilised, the fallopian tube allows the fertilised egg to travel to the uterus for implantation.
Some common causes of fallopian tube blockage are:
- Pelvic Inflammatory Disease (PID)
- Endometriosis (build-up of endometrial tissue in the fallopian tubes, causing a blockage)
- Sexually Transmitted Diseases (STDs)
- History of ectopic pregnancy
- Polyps, debris, or scarring around the fallopian tube
Assessment and Evaluation
Though Mrs S’s uterus, ovaries, and fallopian tubes had a normal appearance externally, the dye injected during the hysterosalpingography revealed a bilateral tubal block. The hysteroscopy showed thin scarring near the tubal openings. Dr Pallavi also performed an endometrial biopsy to rule out tuberculosis (TB) of the endometrium.
Unblocking the Tubes: How is Fallopian Tube Cannulation Performed?
The bilateral tubal block in Mrs S was operated upon by fallopian tube cannulation. This is a keyhole surgery in which two cameras– a hysteroscope and a laparoscope- are inserted into the body to gain access inside the uterus and abdomen. While visualising the abdomen and pelvis through the laparoscope, a fine guidewire was introduced into the uterus and the opening of the fallopian tube. The doctor will use a guidewire to unblock the tubes carefully. A dye is injected into the pelvis to determine the success of the procedure.
The Beginning of Lifelong Happiness
Mrs S was now advised to visit after her periods with an instruction to resume her medications from day 3 of her cycle. This is to stimulate the growth of her follicles. After the rupture of her follicle (a sign of ovulation), Dr Palavi performed a scan. This was followed by IUI (Intrauterine Insemination) of her husband’s semen. Sixteen days after the IUI procedure, a urine pregnancy test confirmed that Mrs A had conceived in the first cycle after removing her tubal block.
Many times, what looks normal may not always be! Silent factor-like tubal blockages can be the reason preventing you from the lifelong happiness of being a parent. However, with the advanced technology and equipment used at Nova Fertility, parenthood is just a few steps away from us!