Tubal Disease

Dr. John Frattarelli and Dr. Anatte Karmon have evaluated and treated many women in Hawaii and elsewhere for fallopian tube abnormalities causing infertility. Although the infertility treatment options with tubal disease are limited often requiring IVF, the pregnancy rates for women with tubal disease undergoing IVF are excellent.

One of the many causes of infertility is tubal disease, in which your fallopian tubes become blocked or damaged. Scar tissue resulting from endometriosis or abdominal or gynecological surgery (bowel surgery, cesarean section, ruptured appendix, etc.) can block the egg from entering or traveling down your fallopian tube to meet the sperm. Infections, such as chlamydia, can damage the cilia (tiny hairs lining the fallopian tubes) that help to transport the egg. Without normal cilia, the egg may not meet the sperm, or if an egg becomes fertilized, it may not be able to travel to the uterus. This can result in an ectopic pregnancy, which can further damage your tube.

Tubal ligation (having your “tubes tied” to prevent pregnancy) can also leave your fallopian tubes permanently damaged.  The Fertility Institute of Hawaii recognizes that tubal reversals are an option for women.  Unfortunately, we generally do not see it as an optimum or cost efficient way to manage a previous surgery that was meant to be permanent. During your consultation and evaluation, our providers will discuss your treatment options to include tubal reversal based on your history and current assessment. For women who have had a tubal ligation, we often find that the present success rates of IVF and pregnancy far exceed the rate of pregnancy of a sterilization reversal.

How tubal disease is diagnosed

Your medical history and a pelvic exam are necessary in diagnosing tubal disease. However, other tests are needed to confirm the diagnosis. You may need one or more of the following tests:

  • Saline Sonohysterogram – a procedure that uses ultrasound to detect masses in your uterus that may be blocking your fallopian tubes.
  • Hysterosalpingogram – a procedure that uses x-rays and a special dye injected into your fallopian tubes, to see if they are open or blocked.
  • Laparoscopy – an outpatient surgical procedure in which your doctor uses a narrow fiberoptic telescope inserted through an incision near your navel to look for and sometimes remove scar tissue or endometrial tissue blocking the fallopian tubes.

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