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Surgical treatment for tubal factor infertility
Advanced Fertility Center of Chicago
Gurnee & Crystal Lake, Illinois
Hydrosalpinx, a blocked right fallopian tube prior to surgical repair
The end of the tube is stuck in pelvic scar tissue to the ovary
Background
Tubal factor infertility accounts for about 20-25% of all cases of infertility.
The treatment for tubal factor infertility is usually either tubal surgery to repair some of the damage or in vitro fertilization (IVF).
The pros and cons of surgery versus IVF are discussed on the tubal factor infertility page.
The pros and cons of tubal reversal surgery versus IVF for women who have had their tubes tied, clipped, or burned are discussed on the tubal reversal versus IVF page.
What can be done to repair damaged tubes?
The options for surgical treatment of tubal factor infertility depend very much on the degree of tubal damage.
Lysis of adhesions can be performed (resection of scar tissue) or blocked tubes can be re-opened with surgery. Various levels of reconstruction in between these two extremes is also possible.
Subsequent pregnancy rates depend upon several factors including the amount of tubal damage that was initially present before the procedure, the degree of damage to the internal lining of the fallopian tubes which can no be corrected, the age of the woman, the situation with the male partners sperm, the skill of the surgeon, and other factors.
Laparoscopy and laparotomy
Laparoscopic repair of a blocked fallopian tube (neosalpingostomy)
Grasping instrument is holding end of tube at newly created opening, "O"
Laparoscopic photo album
Many tubal surgeries can be performed laparoscopically ("belly-button" or "Band-Aid" surgery). This allows the woman to go home the same day, return to work in 3-4 days, and have only small scars (each less than 1") on her abdomen.
However, not all tubal surgeries can be performed as well through the laparoscope as by laparotomy (bigger incision - about 4 inches long). This also depends on the skill and training of the surgeon.
Pregnancy rates and ectopic pregnancy rates after tubal surgery
According to published studies, approximate pregnancy rates by 12 months after tubal surgery are shown below. These numbers are average figures from a group of women that have had tubal surgery. In real life, each case is unique and should be assessed individually.
Type of surgery |
Medical terminology |
Pregnancy rate |
Tubal pregnancy rate |
| Reconstruct
damaged end of tube |
Fimbrioplasty | 50% over 1-2 years | 12% of pregnancies |
| Cut away scar tissue on tubesor on ovary | Salpingolysis Ovariolysis |
45%
over 1-2 years |
6% of pregnancies |
| Make
opening in blocked tube |
Neosalpingostomy | 25% over 1-2 years | 25% of pregnancies |
| Reconnect tubes after tubal ligation | Tubal reanastomosis | 40-70% over 1-2 years | 4-15% of pregnancies |
| In
vitro fertilization (for comparison) |
IVF | 50-60% per attempt
at our clinic (age < 35, blocked tubes) Our IVF pregnancy success rates |
1-5%
of pregnancies (women with blocked tubes) |
Advanced Fertility Center of Chicago
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Gurnee, IL
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Crystal Lake, IL
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