Skip to main content

Fix The Tubes or Lose The Tubes

Image
By
The American Society of Reproductive Medicine has just issued it's new Committee on the role of tubal surgery now that we also have in vitro fertilization (IVF). Women who have had prior PID, prior endometriosis, prior pelvic surgery, previous tubal ligation, or other chronic vaginal  infections may have blocked fallopian tubes as the reason for their infertility. For many years we only had the ability to perform open surgeries to correct these problems and help women with tubal blockage have a child. Then for many years physicians were erring on the side of IVF because the pregnancy rate per cycle is slightly better than say putting cut tubes back together. But tubal surgeries can be very cost effective and fixing the tubes, if it works, will allow women to be fertile for the years going forward, not just that one cycle of IVf. So the committee has weighed in on a number of issues, first they have said that a firm diagnosis of the problem should be achieved. And if there is blockage on the x-ray or ultrasound, consider repeating the test, sometimes they will show openings in a second round. Also the committee has indicated that a tube damaged beyond repair should be removed. Tubes that only have a bit of scaring at their end should be opened surgically to try to correct fertility issues. Some women with prior tubal ligations should try to have their tubes reconnected not just have IVF. Some women with blockage at the point where the tube implants could have a type of drilling procedure that is done under ultrasound, x-ray or with the hysteroscope (operating within the uterus) that just reopens the blocked portion. So the committee reminded women that some tubes can be fixed, others you may need to lose by surgical removal to improve your chance at fertility.
Labels:

Comments

Post a Comment

Thank you for your comments and questions. WE hope you will buy our book, https://www.gynogab.com/shop This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see

Popular posts from this blog

You Have an IUD: But a Positive Pregnancy Test

By
Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...
199 comments
Read more

Passing Your Uterine Lining, Menstrual Period Norms

By
Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously.  It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods  Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...
311 comments
Read more

Post-Endometrial Ablation Syndrome

By
If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...
647 comments
Read more