Posted by: Amra

Dear doctor,

Ten days ago I have undergone laparoscopy to remove ectopic pregnancy together with the left tube where the pregnancy occurred. My right tube is also blocked. I am 32 and I have successfully carried and gave birth to a baby in 2007. After that, I have had two miscarriages and the last one was two years ago with vacuum aspiration performed at that time. I am curious to know my chances to “unblock” my remaining tube? Thanks in advance. 

Answer by: Martina Bračun, MD

Dear Amra,

Infertility is defined not only as inability to conceive but also as inability to carry pregnancy to term, which seems to be your case. Tubal damage is one of the most common causes of infertility. The main cause of tubal damage is silent pelvic inflammatory disease, which shows no symptoms at all. The most usual cause of such inflammation is infection by Chlamidia trachomatis. In addition, tubal damage can be caused by endometriosis, inflammatory bowel disease or by damage caused by previous surgical interventions. Women who have damaged tubes are hardly to conceive without assistance and should they do, the pregnancy is likely to be ectopic.

According to American Association for Reproductive Medicine, after an intervention to fix damaged or blocked tubes chances for spontaneous pregnancy are very low. You will most probably need an IVF if the intervention had shown blockage, fluid-filled tube or numerous adhesions between the tube and the ovary. If laparoscopy has shown undamaged but blocked tube, chances of normal pregnancy are around 20 to 30 percent. The only way to up your chances is if an intraoperative procedure shows only a few ahesions between the ovary and the tube which are then removed.

Considering your age, the fact that you’re missing a tube with the remaining one being damaged and your miscarriages, I would suggest additional testing followed by an IVF.

Best regards,

Martina Bračun, MD