The fallopian tubes are muscular conducts with an approximate length between 10 and 12 cm connecting ovaries with the uterus. Their main function is to make fecundation possible, as they allow one or more oocytes to travel along the uterine cavities to find the spermatozoids.

In order to achieve fecundation, the tubes need to be permeable. This means that there should be no obstruction that would hinder the meeting between oocyte and spermatozoid.

They also need to have great mobility as it is with suction movements how they are able to catch the oocyte in the peritoneal cavity once it has ovulated in preparation for the spermatozoid to fertilize it.

The obstruction of the fallopian tubes is one of the main causes of female infertility as it prevents communication between ovaries and the uterus.

Obstruction can be total, when both tubes are obstructed, or partial when only one is.

– Partial obstruction lowers the chances of fertilization, nevertheless it does not make it impossible. We can achieve pregnancy but it can take longer than usual. Partial obstruction means some eggs will be able to go through and thus get to the point of a possible fecundation with a spermatozoid.

– Total obstruction, means fecundation is not going to be possible as both spermatozoid and oocyte will not be able to meet.

There are several causes leading to the obstruction of the fallopian tubes, amongst them:

– Sexually transmitted infections

– Acute inflammation of the tubes

– Endometriosis

– Side effects from the use of an IUD as contraceptive method

– Wounds from abdominal chirurgical interventions

– Ectopic pregnancies or complicated abortions.

– Problems in previous pregnancies.

To be able to analyze the permeability of the fallopian tubes we can perform a Hysterosalpingography (HSG), an X-Ray consisting of an injection on the uterus neck with a contrast solution inside that will fill up the uterine cavity and the tubes, and which will come out to the inside of the abdomen.

We can also perform a hysterosonography (HSN) with serum that will be introduced to the uterine cavity and will travel along the tubes. This test has the advantage that it can be done in a gynecologist’s office.

Results show that chirurgical intervention to permeabilize fallopian tubes does not deliver good results when one tries to get pregnant. Therefore, assisted pregnancy treatments are recommended. Normally an IVF is recommended.

Laparoscopy is a minimally invasive surgical procedure applied to women to detect and treat the conditions causing infertility. It’s a thin tube-like flexible device with a high-resolution camera and high-beam light attached to one end that allows a fertility doctor to see and examine all of the abdominal organs, including the uterus, fallopian tubes, and ovaries, located in the pelvis at the very bottom of the abdomen, and diagnose abnormalities that could interfere with a woman’s ability to conceive a pregnancy. Endometriosis, pelvic adhesions, ovarian cysts, and uterine fibroids are the most frequent conditions that lead to infertility.

In the first pregnancy analysis we will be asked for the blood group. If it is Rh-, it will be determined if there is Rh sensitization, that is, if there are Rh antibodies present in the blood. If the mother is not Rh-sensitized, she can be given Rh immunoglobulin injections to prevent sensitization and prevent the mother from generating antibodies. The injections work for a short time, so treatment must be repeated with each pregnancy.

If the mother is already sensitized, the injections will not work. In this case, the fetus will be monitored frequently because it is a high-risk pregnancy. The treatment of the baby will be determined mainly according to the severity of the anemia. If it is mild, it will only be monitored during pregnancy and at birth. If the anemia worsens, delivery may be brought forward, or even a perinatal transfusion may be required.

In the past, Rh incompatibility could be mortal. Today, thanks to testing and follow-up, babies born with this hemolytic anemia are in the vast majority of cases born without major complications.

Chlamydia infections may reduce your chances of having children, but they don’t always cause fertility problems. Chlamydia can lead to pelvic inflammatory disease which can cause damage to the fallopian tubes and even damage to the ovaries as well. This can increase the chances of difficulty getting pregnant, tubal pregnancy (ectopic pregnancy) or low egg supply (diminished ovarian reserve).

Get treated ASAP if you have Chlamydia at the moment, and see a Fertility MD (Reproductive Endocrinologist) if you are trying to conceive now or in the future.

The thyroid hormones interact with the reproductive ones, oestrogen and progesterone, to preserve the normal ovary activity and the egg maturation process. Therefore, when there are thyroid problems, the female fertility may be affected.

If the thyroid gland releases an excessive quantity (hyperthyroid) or insufficient quantity (hypothyroid) of hormones it may cause:

– Ovulation alterations;

– Irregular periods;

– Infertility or problems in getting pregnant;

– Problems to successfully reach a full-term pregnancy.

When the thyroid gland doesn’t work well all our endocrinal system might become unbalanced. FSH and LH, the hormones that control the ovulatory cycle, may get affected provoking an anovulation. When this happens no egg is released and, consequently, the fertilization is not possible and there will be no pregnancy. For that reason, one of the fundamental medical tests regarding the female fertility is the hormonal profile, which includes the thyroid hormones.

Many times it is possible to recover the ovulation and therefore, to get pregnant naturally by restoring the hormonal values with some medication. However, if this is not stabilised with the hormonal medication it is advisable to turn to a fertility treatment.

After getting pregnant it is important to go to a specialist regularly in order to keep the thyroid gland and the hormonal levels under control.