Tubal Damage and Impact On IVF

 Tubal Damage and Impact On IVF

Female reproductive organs comprise of – Uterus,Fallopian tubes and ovaries.Altered function in any of these can land up into Assisted Reproduction with IVF as the last option with maximum success rates

Any discussion of the potential risks and benefits should also highlight the potential effect of delaying IVF treatment,

especially in older patients where other factors may

play the determining role.

Whenever we as patients are told about the status of fallopian tubes which normally need to be functional and dynamic for natural pregnancy to happen but when affected then it can vary from-

·      Complete blockage of both tubes

·      Unilateral blockage

·      Patent but non functional

·      Spastic

·      Blockage can be due to spasm,debris or pathology

·      Damage can be by Infection like Tuberculosis,scarring,post surgical impact,adhesions

·      Fluid accumulation intubes-Hydrosalpinx

Depending on the status next step will be either-As whether its damage or dysfunction

·      Try to open them by laparoscopy

·      Or Directly go for IVF

 But the dilemma is as whether to carry out IVF  directly or undertake tubal surgery – answer to this is based on –

·      Clinical assessment of the severity of tubal damage

·      Age of the patient

·      Availability of specialized surgical services and IVF

Similarly second doubt which comes in mind is the impact of tubal dysfunction on IVF outcome  .Although tubal disease in

general is not associated with poor outcome from IVF,

there is increasing evidence that distal tubal disease

associated with hydrosalpinx may affect the chances

of success from IVF treatment. Many studies have shown that it can negatively influence the chance of success with IVF by decreasing implantation rates such that as per a combined study it was observed that there were

differences in pregnancy rates after IVF in tubal

infertility with and without hydrosalpinx, pregnancy

rates of 31.2% were observed in the absence of

hydrosalpinx and 19.7% in the presence of hydrosalpinx

Conclusion- Each patient is different so cannot apply blanket treatment to all.Need a basic work up and scrutiny before planning treatment protocol.If beginning is correct then we can have best outcome at end.Needs a systematic and Individualised approach