TUBAL DAMAGE
It is pertinent to know that patent (open) tubes are necessary for conceiving but we should understand that the tubes are not just pipes through which sperm, egg and embryo must pass to achieve intrauterine pregnancy.
They are vital and sophisticated organs that serve intricate functions in the reproductive process. The tubes transport sperm in the direction of the ovary, while at the same time, the fimbriae (petal like extrusion) apply themselves to the ovary from which the egg is ovulating in order to pick up the egg and carry it back down the tube into the uterus. It is on the way that the egg encounters the sperm and fertilization occurs. Thereafter the embryo is transported to the uterine cavity to be implanted there.
TUBAL FACTOR AND IUI
Even if one fallopian tube is patent, then ovulation induction and IUI may be a positive option. However if the tubes are blocked, laparoscopy may be advised to assess the degree of tubal damage.
If the tubes are found to be scarred or damaged then surgical intervention will be required. Though some tubal problems are corrected by surgery, women with severely damaged tubes are unlikely to get pregnant. Then IVF or invitro fertilization is an option. At times removal of the tubes prior to IVF may be required.
If there is fluid collection in the tubes, the condition is called Hydrosalpinx.
OVARIAN STIMULATION
The first step in IUI for women with single patent tube is to commence ovarian stimulation (OS). In patients with single patent tube who start an OS cycle the chances of proceeding to IUI is greater though it should be understood that cycle cancellation rates are significantly higher in patients with single patent tube. Most of the time it is due to absence of follicle on the side of patent tube. In such patients we ask them to try normally. We have come across patients who got conceived even though the follicle developed is not on the side of patent tubes. Pregnancy rate were found to be high after the IUI procedure.
