What is the fallopian tube & its part?

Fallopian Tubes, basically, if one has to simply understand, are a pipeline that connects the Ovary and the abdominal cavity, also called the Peritoneum to the Uterus.

Fallopian Tubes are typically 10-12 cms in length and consist of a fimbrial end, which is close to the ovary; then comes the ampulla, which is a broad portion of the tube, followed by the mid-tubal region and finally ending in the cornua, which is the connection of the tube to the uterus.

Each of these parts is unique to the fallopian tube as they carry out unique functions.

Understanding the Role of Fallopian Tubes in Natural Conception

1. The Importance of Fallopian Tubes in Fertility

The Fallopian tubes are vital for natural conception. They act as pathways for sperm to reach the egg and are where fertilization occurs. If blocked or damaged, pregnancy becomes difficult.

2. The Fimbrial End: Capturing the Egg

The fimbriated end of the fallopian tubes plays a crucial role in capturing the egg released during ovulation. It contains cilia, small hair-like structures that push the egg towards the inside of the tube. During a diagnostic hysteroscopy and laparoscopy for fertility assessment, doctors closely examine the microstructure of this part of the fallopian tubes, a process known as “salpingoscopy.” This requires specialized instruments to assess the internal structure of the fallopian tubes.

3. The Ampulla: The Site of Fertilization

The next part, the ampulla, is where fertilization actually takes place. The egg remains viable for fertilization for about 12 hours following ovulation. If natural intercourse or IUI occurs during this window, there is typically a good concentration of sperm inside the fallopian tubes, allowing for successful fertilization. In contrast, sperm can survive in the female reproductive system for around 48 to 72 hours.

4. The Journey of the Embryo Through the Fallopian Tube

Once fertilization occurs, the embryo begins its slow journey towards the uterus, taking approximately five days to travel just 7–8 cm. During this time, the fallopian tubes secrete a fluid known as Human Tubal Fluid (HTF), which nourishes the embryo, supports cell division, and helps the embryo grow from a fertilized egg to a 120-cell Day 5 blastocyst. Interestingly, most commercial IVF media are designed to mimic this HTF.

5. The Cornua: Final Step Before Implantation

The final and narrowest part of the fallopian tube is called the Cornua. At this stage, the fertilized Day 5 embryo, or blastocyst, moves from the fallopian tube into the uterus, where implantation takes place.

1. Traditional Method: HSG (Hysterosalpingography)

Fallopian tubes are to be assessed in every patient who is planning for conception. The traditional method of assessment is by performing a procedure called HSG (Hysterosalpingography). This involves pushing a medical dye inside the uterus and observing its passage through the uterus via an X-ray. The X-ray plate is then analyzed by a doctor to visually assess the spill.

– Challenges with HSG

One of the primary issues with HSG is the pain it causes. As a result, the very idea of HSG or tubal ligation makes many women uncomfortable, leading them to avoid the procedure. Furthermore, fertility-related support groups often discuss HSG, sometimes sharing information that may be correct or incorrect, increasing anxiety among couples.

2. The Modern Alternative: Saline Sonosalpingography (SSG)

These days, HSG is considered outdated and has been replaced by Saline Sonosalpingography (SSG).

– Why SSG is Better

One of the most common questions is whether SSG is also painful. The difference here is that in SSG, the dye itself is composed of a local anesthetic, making the procedure virtually painless. Women who undergo SSG generally feel much more comfortable compared to those who undergo HSG.

– Additional Benefits of SSG

SSG not only examines the fallopian tubes but also offers a 3D study of the tube and simultaneously evaluates the internal structure of the uterus. This comprehensive approach provides crucial information for assessing the female reproductive system. The illustration of the SSG procedure is presented in a photo for better understanding.

3. Fallopian Tubes: Their Role and Vulnerability

Fallopian tubes play a crucial role in fertility. Due to their connection to both the peritoneum and the uterus, they are at risk of becoming blocked, particularly in cases of infection.

– Common Causes of Tubal Blockage

Typically, tubal blockages result from silent infections. Among Indian women, common infections like Chlamydia and Gonorrhea often lead to tubal obstruction. Indian women are generally more susceptible to tubal blockages due to the high prevalence of endemic pelvic infections in the country.

Fallopian tube blockages are a common cause of infertility and are typically classified into three types:

1. Cornual Blocks
2. Mid-Tubal Blocks
3. Fimbrial Blocks

1. Cornual Blocks: The Easiest to Treat

Among the three types, Cornual Blocks are the easiest to treat and have the best outcomes. The treatment involves a procedure called fallopian tube cannulation.

– Procedure and Success Rate

This delicate procedure requires precision and control to avoid perforating the tube. When performed by experts, it offers maximum benefits. After surgery, many patients with Cornual Blocks successfully achieve natural pregnancy.

2. Mid-Tubal Blocks: Complex to Treat

Mid-Tubal Blocks are more challenging as they do not respond well to laparoscopy. This is primarily due to intraluminal compromise, which results in very poor outcomes.

– Surgical Approach

Even with laparoscopy, the success rate is about 45% when performed by an expert. Mid-tubal blocks caused by adhesions and endometriosis require skilled surgical intervention to carefully reopen the tubes.

3. Fimbrial Blocks: Advanced Surgical Skill Required

Fimbrial Blocks are the most complex and demand a high level of surgical expertise. One of the most effective procedures for these blockages is Fimbrial Repositioning, which is performed in India by a few specialists like Dr. Jay Mehta.

– Success Rate

Dr. Jay Mehta is known for his surgical proficiency, offering high success rates in Fimbrial Block treatments. Book your consultation with Dr. Jay Mehta, the leading expert in infertility and blocked fallopian tube treatment in Mumbai, India!

• Antibiotic Therapy

After surgical procedures, patients are often prescribed antibiotics to prevent infection and aid in healing.

• Ayurvedic Treatments: Limited Success

Some patients opt for alternative therapies like Uttar Basti, an Ayurvedic treatment for blocked tubes. However, this therapy requires skilled preparation, multiple sessions, and the success rate remains suboptimal.

Debunking Myths: Diet and Exercise

Contrary to popular belief, there are no magic remedies like diet, exercise, or nutrition that can unblock fallopian tubes. Patients should be cautious of such emotional gimmicks and focus on proven medical treatments.

The Importance of Healthy Fallopian Tubes

A healthy fallopian tube is essential for fertility. Optimizing tubal health significantly increases the chances of conception. Consulting with a skilled expert like Dr. Jay Mehta can make a substantial difference in fertility outcomes.