Clogging of the tubes is one of the most common causes of infertility. Fallopian tubes
extend from the ovaries to the uterus on both sides of the body, and blockage of both tubes
obstructs pregnancy.
The infundibular part of the fallopian tubes is closest to the ovaries. It is the proximal part and from here extensions called fimbria
extend to the surface of the ovary. Fimbriae are covered with thin hairs (cilia
cells) like hairs. During the ovulation period, under the influence of hormones, the fimbriae sweeps over the ovaries with gentle movements and catches the excreted ovum. While the captured ovum is dragged towards the Fallopian tube through fimbria and cilia, the ovum sometimes encounters sperm here and is fertilized. It continues its way in the tube by feeding as a zygote and falls into the uterus.
The widest part of the tube is the ampoule region, and the narrowest part is the isthmus part at the utero tubal junction
.
There is an excess amount in the infundibular and ampullary regions of the fallopian tubes due to the effect of estrogen
There are ciliary cells and peg
cells between them, which increase under the influence of the progesterone hormone, which produces tubular fluid. The fluid produced by these cells also increases the capacitation of sperm.
and is very nutritious for the sperm, oocyte and zygote. Estrogen and progesterone hormones are very important hormones for tubular
functions.
Occlusion of Fallopian Tubes
Fallopian tubes are classified according to the area where they are blocked:
Distal. Tubal Obstruction: If the fallopian tubes become blocked at the end close to the ovary, it is called hydrosalpinx. It can be blocked most commonly due to sexually transmitted diseases called chlamydia
. If left untreated, adhesions will occur in both the tubes and the pelvis. If the fimbria
is damaged and sticks, its function of catching the ovum released during ovulation is eliminated
and infertility problems occur.
Clogging of the Middle Segment of the Tube: Mostly during the ligation of the tubes. There may be a blockage in the middle
segment. 75% success rate is achieved in the operation performed to open the tubes.
Proximal Tubal Obstruction: The part of the tubes close to the uterus. It means there is a blockage in the pipe
. Miscarriages, pelvic infections, stillborn pregnancies and birth control methods that concern this part are the most common causes of proximal tubal obstruction.
The Most Common Causes of Obstruction in the Fallopian Tubes:
Pelvic operations such as cesarean section
Pelvic inflammatory diseases
Endometriosis
Ectopic pregnancy
Myomas
Tubal ligation
Genital tuberculosis, which is most common in underdeveloped countries
Diagnosis of Fallopian Tube Obstruction
Hysterosalpingography (HSG): It is an xray test. In order to understand whether there is a blockage in the fallopian tubes
, the uterus is first filled with a contrast dye material
(radiopaque substance) through a cannula applied through the vagina, and then it is allowed to pass through the tubes and most
Contrast material is applied, observed under scopy, and then an x-ray film is taken. If
there is an obstruction in the tubes, the contrast material cannot pass through the tubes.
Chromotubation: Although it is a similar procedure to the HSG procedure, chromotubation
must be performed during a surgical procedure (laparoscopy procedure). is carried out. Under laparoscopic observation
dye (most often methylene blue) is injected into the uterus through a vaginally applied cannula
If the tubes are open, this dye then passes through the tubes and spreads to the peritoneum.
can be monitored.
Sonohysterography: It is a non-invasive procedure performed under ultrasound guidance to determine the permeability of the tubes.
Physiological saline is injected into the uterus with a cannula under sterile conditions, allowing fluid to pass through the tubes while filling the inside of the uterus. At the same time, ultrasound detects fibroids, polyps or tube obstruction, hydrosalpinx, etc. can be observed.
Opening the Fallopian Tubes:
Depending on the cause of the blockage and the blocked segment of the Fallopian tubes, if appropriate
The blockage in the Fallopian tubes can be treated with various medical and surgical procedures. is attempted. Infertile
When the tubes are blocked in infertile patients, in vitro fertilization is often preferred instead of surgical treatment
Article Writing Date: 08.08.2016
Op. Dr. Kutlugül Yüksel
Gynecology and Obstetrics Specialist
Eskişehir road, 9. Km, No: 266, Tepe Prime
C Block No: 45 Ankara
Tel: 0312 4258530
Mobile: 0532 6121783
www.kutlugulyuksel.com.tr
www.ankarakadindogumcu.com
Read: 0
