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I am happy to answer your question in this venue, as I did when you contacted me directly. I am sure others have the same question. If tubes are blocked at the end near the ovaries, fluid begns to collect. Having tubes filled with this fluid impairs embryo implantation with IVF. The fluid needs to be permanantly removed. One way to accopmlish this is to remove the tubes.
Good luck.

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Are there other options aside from tubal removal? Is there a difference between removing them all together and having them sealed off at one end as far as outcomes are concerned?

Thanks.

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For my patients, I open the "ovary end" of the tubes, widely, to drain it. To prevent the increased risk of tubal pregnancy, I block the "uterus end" of the tubes. I have a concern that removing the tubes wil compromise blood flow to the ovaries.
Good luck.

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Dr. Jacobs,

I have a blocked tube, but my RE says that the blockage is at the base of my uterus not at the ovary end. He says that we do not need to remove my tube since there is no fluid leaking into my uterus (since it is blocked at the gateway to the uterus rather than the ovary). Do you agree? I have read some postings and some data on the fact that blocked tubes can cause a problems during IVF.

I am in the middle of my second IVF attempt. I take my pregnancy test tomorrow.

Thanks for your advice!

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If you really do not hve fluid collection in your tubes, you do not need to remove them. If your tubes are blocked in the portion of the tube which passes through the thich uterine wall, you may be able to open them with an out patient procedure, and you may not need IVF, at all.
Good luck.

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A proper investigation of your tubes would determine if one or both is blocked. I do an HSG. Even without an HSG, ultrasound usually will detect fluid filled tubes. There are data reported to demonstrate that routine immunology testing is not cost effective as a routine screen for IVF.
Good luck.

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Dr. Jacobs,

My second IVF is now officially a failure. I do have to have IVF since my husband has a vasectomy. My doctor does not seem concerned about my one blocked tube since it is blocked at the base of my uterus, not my ovary. He says that there is only a concern for IVF patients if there is a blockage at the ovary end. ??

I had 5 blastocyst (2, 6-day blasts were put back during a fresh cycle and 3, 7-day blasts were put back during a frozen cycle.) Both attempts were failures. My doctor says that I do really well during the egg prep phase. I originally had 18 harvested and 14 fertilized. He said the egg quality was very good. Do you think this tube blockage situation could cause problems for implanting? Also, note, my uterine lining was considered a "perfect 10" before the FET. My doctor says that he see no reason that I can't get pregnant (no problems at all) and that it is just a flip of the coin. This is not very comforting when I only have 1 insurance-paid attempt left !! Can you suggests any tests while my insurance is still willing to pay?

Ugh... please let me know what you think.

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There are still things we do not understand about embryo implantation. One of the things I do to try to test the potential for an embryo to implant is testing for an endometrial adhesion molecule, apparently important for an embryo to implant.
Good luck.

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