The success rates following tubal surgery will depend on the severity of the disease. Careful pre-operative assessment, including semen analysis and often hysterosalpingography and laparoscopy, is required.
The commonest site of tubal damage is at the fimbrial end (opening near the ovaries –Figure 9.1), with birth rates after surgery in the order of 25 per cent. Surgery for proximal tubal occlusion (the blockage is close to the uterus) is more successful, with live birth rates of 50% and ectopic rates of 10%. Just over a half of intrauterine pregnancies following tubal surgery may occur more than one year after surgery. Reversal of sterilisation, with removal of clips and re-anastomosis (reconnection), carries a relatively high success rate of up to 80%.
Tubal microsurgery involves the use of magnification as well as the adoption of a set of techniques including the use of special instruments, minimal handling of the Fallopian tubes and fine non-reactive suture material. There have been no controlled trials to prove conclusively an advantage over conventional surgical techniques but several surgical teams have reported improved success rates. It is technically possible to transplant Fallopian tubes and large numbers of these organs would undoubtedly be donated by women undergoing sterilisation or hysterectomy(hysterectomy). Research interest in this area seems to have diminished following the development of IVF (24).
Related Medical Abstracts - Click on the paper title:-
- Laparoscopic management of hydrosalpinges before in vitro fertilization-embryo transfer: Salpingectomy versus proximal tubal occlusion (2001)
- Cochrane review: Post-operative procedures for improving fertility following pelvic reproductive surgery. (2000)
- Pharmacological adjuvants during infertility surgery: A systematic review of evidence derived from randomized controlled trials. (1999)
- Ultrasound-guided aspiration of hydrosalpinges is associated with improved pregnancy and implantation rates after in-vitro fertilization cycles. (1998)
- In-vitro fertilization outcome in women with hydrosalpinx (1996)
Please click on the required question.
- 1 What are the objectives of infertility treatment?
- 2 Why have I been advised to take folic acid as part of my infertility treatment?
- 3 Although my ovaries have eggs in them, my tests show that I am not releasing them (anovulation) and this is causing infertility. How can this be treated?
- 4 If I take drugs to induce ovulation (ovulation induction) for my infertility, are there any risks?
- 5 How is ovulation induction treatment for infertility monitored?
- 6 How does clomiphene citrate work for infertility?
- 7 How effective is clomiphene in the treatment of infertility?
- 8 Could I experience any problems whilst taking clomiphene?
- 9 Is there any advantage in having an injection of HCG to ensure ovulation?
- 10 How does tamoxifen work?
- 11 How can hyperprolactinaemia be treated?
- 12 How does metformin work?
- 12A How does letrozole work for infertility?
- 13 How do gonadotrophins work?
- 14 What are the risks for me if I receive gonadotrophin therapy?
- 15 What are recombinant gonadotrophins?
- 16 What is ovarian hyperstimulation syndrome (OHSS)
- 17 How is ovarian hyperstimulation syndrome treated?
- 18 How does electrocautery (ovarian drilling) work for infertility associated with polycystic ovary syndrome (PCOS)
- 19 I have been found to have endometriosis. How should this be treated to improve my chance of conceiving?
- 20 Tests have shown that I have problems with my Fallopian tubes. What can be done about this?
- 21 I have fibroids. How should these be treated to improve my fertility?
- 22 My post-coital test has shown that my mucus is stopping the sperm from swimming (mucus hostility). What can be done?
- 22a How can male infertility be treated?
- 23 When can intrauterine insemination (IUI) improve our chance of achieving a pregnancy?
- 24 What is in vitro fertilisation (IVF) and embryo transfer (ET)
- 24A IVF single or double embryo transfer?
- 25 What is intracytoplasmic sperm injection (ICSI)
- 26 How do tubal surgery and IVF compare?
- 27 What are egg donation and egg sharing?
- 28 What is selective embryo transfer?
- 29 Investigations have shown no obvious cause for our difficulty achieving a pregnancy. Are there any treatments for our unexplained infertility?
- 30 We have tried a variety of treatments but we still have not achieved a pregnancy. Why should this be?
- 31 We are finding the investigation and treatment of our fertility problems to be ever more stressful. Can stress be a cause of infertility?
- 32 How can we determine which fertility unit is likely to be the best for us?
- 33 Where can I obtain more information?
- 34 Infertility Support Groups.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
- Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.
David Viniker retired from active clinical practice in 2012.
In 1999, he setup this website - www.2womenshealth.com - to provide detailed
information many of his patients requested. The website attracts thousands of visitors every day from around the world.
If you would like advice on how to make more from your website, please visit his website Keyword SEO PRO or email him on david@page1-on-google.com.