One of the most common reasons for a woman being unable to conceive is blocked fallopian tubes, in which case she will be offered surgery to unblock them. The HFEA estimates that around a third of all female patients with infertility problems have damaged fallopian tubes, possibly caused by previous and possibly unknown infections.
Surgery for blocked fallopian tubes
The main advantage of surgery is that, if it works, a couple will be able to go on and have one or more ‘spontaneous’ conceptions, without the need for any further invasive treatments. However, the chances of success decrease depending on how great the blockage or the damage is, and unfortunately a few women who undergo surgery find that their tubes become blocked again.
Some women are now being offered a relatively new surgical treatment which is a form of salingostomy. A catheter is passed through the cervix and into the uterus; dye is then injected into the fallopian tubes to show the source of any blockage. Once the point of the blockage can be seen, a thin wire is then passed down the tube to unblock it. The woman can be awake for this procedure so it carries fewer risks than surgery which requires a general anaesthetic.
Surgery may also be recommended if a woman has endometriosis. It may be possible to remove some of the cells with a laser during a laparoscopy, or through more extensive surgery. As with tubal surgery, it is necessary to allow at least a year afterwards to get the full benefit of the surgery, if any, then it may be a case of having to proceed to IVF treatment. Surgery may also be advised if the woman has adhesions or fibroids within her uterus, or to open a narrow or scarred cervix and improve fertility. It is sometimes also carried out to treat polycystic ovaries.
Men may be recommended surgery if the ducts through which the sperm travels have become blocked, or to remove a varicocele (swollen vein) if this may be interfering with sperm production or movement. This procedure can be carried out under local anaesthetic.