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Tubal Factor Infertility

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a blog by Dr. Mark Payson, Dominion Fertility, July 7, 2014

“Ana” started crying. We had just reviewed the results of her initial fertility evaluation and the results indicated that her fallopian tubes were blocked. Her husband’s sperm count was also a little low, but she focused on her own “failure” with “broken tubes.”

Tubal factor infertility – or any situation in which the fallopian tubes are nonfunctioning (blocked, absent, dilated, etc) is one of the most common causes of infertility. It can be due to an infection in the past, a history of appendicitis, the presence of fibroids, a prior surgery, even sometimes after delivery or cesarean section. Some women will have no history of any of the above and still have blocked tubes, or may have had an infection as a teenager that was never recognized.

The good news about tubal infertility is that it is very treatable, in fact in vitro fertilization (IVF) was developed specifically to treat this condition, as the tubes are not involved in the IVF process. If the tubes prevent the egg from traveling into the uterus, we simply need to bypass the tubes, and the chances of pregnancy are very good! Most women with tubal fertility problems have normally functioning ovaries, and succeed within their first several IVF cycles. Either stimulated or natural cycle IVF are very successful treatments for this condition.

I explained all this to Ana, which did help somewhat, but most of all was the fact that that very day I had another patient who I was discharging to her obstetrician with a normal 7 week pregnancy, and yes, she had had blocked tubes and underwent IVF!

I have high hopes for Ana moving forward, and reminded her that yes, the fertility process is a journey, and sometimes takes a little while, but with the right treatments usually succeeds.


Comments (3)

If the fallopian tubes are dilated (hydrosalpinx), this has been shown to decrease pregnancy rates with IVF by about 20%. Therefore it is generally recommended that the tubes be removed before an IVF cycle. The thought is that the fluid that builds up in the tube may flush back into the uterus and be toxic to the embryo, or prevent normal development of the lining of the uterus. Alternative to removing them, the tubes can also be "clipped" which seals them off. But you should always feel free to ask your doc why they are proposing a certain treatment, there should be a reason! Best Mark Payson, MD

My RE is suggesting removing my tubes prior to IVF. If they are blocked why do I need to have them removed?

Hey Lydia! I'm sorry to hear that you're having concerns. The doctor didn't provide you with a reason as to why he or she wanted to remove them all together prior to IVF? If I were you I would inquire why they want to remove your tubes. If you would like a second opinion with a different doctor though I'm more than happy to help you find a different doctor so that you can get a second opinion to ensure that you are making the right choice if you decide to remove your tubes. Feel free to email me directly at

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