A Little Anatomy Lesson for us Tubie Girls

Below is a picture of the uterus, fallopian tubes, and ovaries.

First of all, the hard news. It is impossible to get pg. naturally without tubes or if both tubes are blocked. There is no way for the egg to meet the sperm and get into your uterus if it can't go through at least one of the tubes. The uterus has 3 openings. One is the cervix which leads directly into your vagina. The other two are through the tubes. When you tubes are removed or blocked, these openings are sealed--they become stubs and/or are closed.

The only way for the sperm to get to the egg is through your tubes. So conception cannot occur naturally without tubes. Implantation cannot occur naturally without tubes because there is no path into the uterus without tubes. Eggs that are in your abdominal cavity cannot make it into the uterus if there is not at least one good tube to catch it and get it there.

It IS possible for women with one tube to get pg. from either ovary. There is a small but still possible chance that an egg will migrate to the good tube from the ovary on the opposite side. I was told by one doctor that this "small" chance was actually 20%. Inside of your body, your reproductive organs are not as symmetrical as they appear in the picture below.

If your tubes are blocked, there is a chance of filling with fluid. When a tube is filled with fluid, it is called a Hydrosalpinx (which means "water tube"). This fluid can back up into the uterus and cause implantation problems. Most RE's will recommend that women with blocked tubes have the blocked tube removed before having IVF. Many doctors feel that removing blocked tubes increases the pregnancy rates with IVF.

What about having blocked tubes repaired? Some RE's are willing to attempt tubal repair. Some RE's feel that blocked tubes cannot be successfully repaired through surgery to make them functional. The tubes are very very small and very very delicate. The surgery can damage the fimbria (these are the small hairlike things at the end of the tube that help to guide the egg down into the uterus) so that, although open, the tube will not be fully functional. Statictically, most surgically opened tubes will not still be open after a year.

Still, we have ladies here on this board who have gotten pg with twisted, damaged, or surgically repaired tubes.

Some ladies come here wondering how it is that they still get their period even though their tubes are blocked. The fact is that a woman is still capable of getting her period regardless of the condition of her tubes as long as she still has her ovaries and her uterus.

Your uterus prepares for pregnancy every month. After your period is over, the uterus starts prepare for pregnancy by building a lining. Mid-cycle your ovaries release an egg. Without tubes, this egg will go into your abdominal cavity and get absorbed. About 2 weeks later, if the uterus doesn't have an embryo inside of it (which can't happen without tubes because the sperm can't fertilize the egg), it releases the lining and you have your period.

[TRC]

Okay, this is what they need to teach in school. Things are just more complicated than "the sperm meets the egg and you are pg"...this is basically what they teach. They don't tell you that the older you are the harder it is to conceive or just what all it takes to conceive...not to mention all the little silent nasty diseases that make a mess of things in there without you even knowing it, making it impossible to get pg via intercourse.

I think you have a second career here!

Great article on Tubal Infertility:
http://www.infertilitydoctor.com/infertility/tubal.htm

[HSCM]

Thanks for the article.

It talks about the hydrosalpingx a little and could be helpful to someone just learning about it... The internet is a great thing.. one can learn sooo much

The article did only suggest that hydrosalpingx is cause from an STD which can be true but not always... My doctor said it could be from a number of other reasons.. I had questioned my doctor about this because I have never had an STD but I had hydrosalpingx.

Great article though, would recommend anyone read trying to learn more.... it talks about other issues too.

Thanks again.
Ang

I never knew that I had an STD until my laparoscopy. There is nothing else that could have caused the damage that I had. My doctor feels that it was from a chlamydia infection. He says that it is common for women to have chlamydia infections and not know it. My infection was long gone (probably years) by the time we discovered my tubes were blocked.

[blueirises]

Your posting of the article about tubal problems was very informative. My left tube is blocked and I'm waiting to see RE for the first time on 25th. My OB just didn't have anything informative about why I'm blocked. She just gave me Clomid which makes me crazy! I'm wondering how long after a LAP do you have to wait to start TTC again. I'm guessing that it differs with what they find in there, but do you know on average. I'm guessing that I will problably need my left tube cauterized or removed. Also do you know if a HSG shows whether ot not you have Endo? Lastly why can't I open the picture from your original posting...it says there are restrictions.

Thanks for any help you may have for me!

Best Wishes,
Kathleen

[HSCM]

Hi blue....
My OB didn't say much either... I went to the RE and was in amazement on how informative and to the point, but yet sensitive and funny he was.

I had a LAP on the 28th of Dec. I had both tubes removed because of Hydrosalpingx/blockage in both tubes. While they were in there they found and removed a cist and lots of scare tissue and adhesions, even on my liver and diaghram. It wasn't a horrable surgery... I was off the heavy pain pills within two days. I was rather uncomfortable but it got better and better every day. I can hardly tell now that I had surgery.

I started the first part of In-Vetro today with the birthcontrol pill... and it hasn't even been a month since my surgery... so I don't think that it will take long before you can start TTC.

Good luck to you at your appointment on the 25th..... keep us posted.

Ang

[blueirises]

I hope you have success with the IVF. I'm anxiously awaiting my RE appt. to find out what I will be doing next. I'm relieved to know that you do not have to wait a long time after the Lap to start up again. I have a week off in mid Feb so that would be perfect timing if I need the surgery. Hopefully this Clomid cycle will be successful tho, God knows we have been BDing our butts off these past few days! Something better stick! I'll know soon.

Good Luck with everything and thanks for your response

Kathleen

[arti]

First of all, it is very nice “meeting” all of you. I was diagnosed w/ stage III –IV endometriosis back in Jan 2005. My ob./gyn did a laparotomy in March 2005 and recommend I go see a RE. My first RE suggested we go through IVF b/c of the severe endo and scar tissues I had. We took his advice and it resulted in a failed IVF. We decided to change RE’s since we didn’t feel comfortable w/ him from the get go. We love our other doctor (same practice) and he is very thorough. He suggested we do an HSG before we try for the second round and the findings were surprising. The HSG was performed on Dec 19 and he found my left tube blocked w/ a hydrosalpinx and my right tube had some scar tissue/dilated but there was spillage. He suggested we do a lap to remove he left tube because it the fluid in the hydrosalpinx can flow back into the uterus and hurt implantation via IVF.

Well I just had my surgery this past Tuesday, and he had to clip the left tube (he clipped near the uterus) rather than removing it b/c he said the tube was “attached” to my ovary and he didn’t want to risk losing the ovary. Also, he clipped my right tube (near the side of the uterus again) b/c he did the dye test and there wasn’t any spillage on my right tube either and the right tube was dilated. What is surprising is that about a month ago there was spillage. I was sad knowing that I can never get naturally pregnant and am still having a hard time dealing w/ it. My RE said the surgery went well and luckily he found no trace of endometriosis which is a good sign. Before surgery he said if he saw any damage to my right tube as well he would remove/clip it. I am just worried that now I have two fallopian tubes “floating” around which the RE says is fine and it is definitive I can never get naturally pregnant (not like we were having much success anyway, but the hope was always there).

Has anyone out there had their tubes clipped (not removed) and still conceived via IVF? Is the success rate the same/worse if your tubes are clipped vs. removed via IVF?

Sorry for the rambling but it felt good to write out my thoughts.

Any advice/suggestions?


Best wishes to all,
Arti

Arti, I don't think there's any risk with clipping the tubes and leaving them in.

The one thing you might want to think about is immune testing. My RE believes that there is a huge correlation between endo and immune issues.