Reproductive options with blocked tubes
Dear Dr Mitchell,
I am a 30-year-old woman who has been unable to conceive with my husband of three years. He has a child from a previous relationship. I had a ‘tube test’ done which showed that both my tubes are blocked. We are still very hopeful about having a child of our own. What are my options, and where can I go to explore these options?
The problem you have with your infertility can be dealt with. Pelvic Inflammatory disease, secondary to Chlamydia and Gonorrhea, is the usual underlying factor. These are sexually transmitted infections that can sometimes initially show no obvious symptoms and cause silent damage to the Fallopian tubes, causing them to become blocked, thereby preventing pregnancy. Blocked Fallopian tubes can sometimes be successfully repaired to relieve the blockage and result in a successful pregnancy outcome.
However, if the lining of the Fallopian tube is extensively damaged from the infection, then relieving the blockage can result in an ectopic pregnancy. This is a situation in which the embryo becomes lodged in the Fallopian tube instead of being propelled down into the cavity of the uterus for implantation. This results in an emergency situation since the Fallopian tube can rupture and can cause life-threatening blood loss that warrants emergency surgery to remove the Fallopian tube.
Laparoscopic evaluation of the blocked Fallopian tube can be done prior to planning surgery to repair the tubes. This will help to determine the extent of damage to the tubes and if surgery will help.
Surgery to clear blocked Fallopian tubes can be done using laparoscopy or open surgery. In some cases of blocked tubes there is no point in doing surgery to repair the tubes if the damage is extensive. In this case, invitro fertilisation (IVF) can be done with a very good outcome. The process bypasses the Fallopian tubes. The egg is removed under ultrasound guidance and fertilised with sperm from your partner.
The fact that you are young is also good since you should have an adequate number of eggs and good egg quality. Your husband will need a semen analysis to ensure that he is still fertile if the child he had is over two years old.
The Fertility Management Unit at the University Hospital of the West Indies is a fully equipped state-of-the art unit with fertility specialists including doctors, nurses, embryologists and psychologists who are well trained to deal with all your infertility problems. The unit offers diagnostic and operative laparoscopy. The outcome with IVF in this unit is comparable to that in first-world countries.
You can thus pursue laparoscopic repair of your damaged Fallopian tubes. If this is not possible, you can be assessed and IVF undertaken. The cost for this procedure is only a fraction of what it costs in the United States and other countries, thus making it more affordable.
Consult your general doctor or gynaecologist who will refer you to be counselled and have IVF done. If the cost is still prohibitive, then you could consider egg sharing. In this situation you can donate some of your eggs to a suitable candidate who has no eggs or poor egg quality and get a significant discount in the cost which will be shared with the recipient of the donated eggs. Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
