Friday, 5 October, 2007
A leading consequence of infertility in women is fallopian tube blockage. A blockage can be caused by a number of reasons, one of which is fluid retention forming a hydrosalpinx(see picture). A hydrosalpinx is a swollen, sausage-shaped blocked fallopian tube which is often the result of a past tubal infection. When injury causes the end of the fallopian tube to close up, glands within it produce a watery fluid which fills up the tube. Although this watery fluid generally poses no harm to the body, studies conducted on women who had undergone in vitro fertilization have shown that this substance is somewhat toxic to implanted embryos. The women with hydrosalpinges had significantly lower chances for a successful pregnancy as compared with those who had their hydrosalpinges removed prior to implantation.The failure of the in vitro attempts at pregnancy is seen to be rooted on the spillage of the hydrosalpinx fluid into the uterine cavity which houses the implanted embryo. The fluid could dislodge the embryos or kill them thereby resulting in a miscarriage.
In the presence of an infection, the body is often able to naturally fight back and heal itself. However, scar formation may result and cause injured tissues to stick together which is the case in a hydrosalpinx. The injured fimbriae (fingerlike projections at the end of the fallopian tube near the ovary) seal up through adhesions from the scarring brought about by an infection(see picture). Both fallopian tubes are often affected when infection is present. However, a hydrosalpinx is usually seen only in one tube with the other tube left with abnormalities. This is the reason why women with only one hydrosalpinx can also experience infertility.
Hydrosalpinges can be caused by a number of infections and two of the most common are Gonorrhea and Chlamydia both of which are sexually transmitted diseases. Generally speaking, sexually transmitted diseases are the more likely culprits when hydrosalpinges occur. However, they are not the only causes. Any form of injury to the fallopian tube tissues can result to a hydrosalpinx. Some other causes for the formation of a hydrosalpinx are ectopic pregnancies, abortions, miscarriages, abdominal surgeries and endometriosis. These conditions can damage or affect the fallopian tubes and the resulting scar adhesions can likewise seal up the tubes.A hydrosalpinx is often seen to form after pelvic inflammation which can be caused by a number of reasons. Pelvic inflammation, are also often caused by infections and can also result from sexually transmitted diseases. However, other causes exist, including fungal or yeast infections as well as infections from the usage of intrauterine devices. A hydrosalpinx can occur in any woman and the chances of occurrence will increase in the presence of infection-causing microorganisms and/or, injury to the fallopian tubes or to the tissues near them. Unfortunately, it is rarely diagnosed early -if diagnosed at all -because the symptoms are generally mild and some women even experience no symptoms at all. The physical discomforts from the condition are often mistaken to be symptoms of bladder infection or bowel problems.
In mild cases fertility may be restored by opening the tube surgically, otherwise IVF is the treatment of choice. There is some evidence that hydrosalpinx reduces the success rate of IVF and increases the risk of mscarriage. For this reason, some doctors may advise removing, or occluding the hydrosalpinx before the IVF treatment.