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Dan C. Martin, MD
Daniel Clyde Martin, M.D. (901) 347-8331 Updated information is
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HYDROSALPINX
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Surgery is better than IVF with mild damage. |
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IVF is often better than surgery for moderate or severe damage of both tubes. |
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Saving the healthiest tube may be reasonable. |
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Removing the tube is best with severe damage. |
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It may not be reasonable to save a severe tube. |
Before tubal repair is performed, either a sperm count or Huhner’s test is considered. The sperm count can be done at a local lab or at a lab near your home if you are not from Memphis. A Huhner’s test in the office is done near ovulation and about 6 to 18 hours after intercourse. A Huhner’s test is like a pap smear looking for sperm in the cervix.
Although tubal repair is a relatively safe form of surgery, the complications are those of surgery in general. These include infection, bleeding and allergic reactions. Surgery for adhesions and pain may make the adhesions and pain worse. As with any surgery, there is the possibility of infection, damaging other pelvic organs, decreased sexuality, repeat surgery and blood transfusion. Paralysis, colostomy, hysterectomy and death are rare.
These operations are done using laparoscopy (belly-button incision) or laparotomy (open surgery). Open surgery may be less expensive and may be needed for emergency. These are usually done as an out-patient. Activities can usually be resumed in 1 to 4 weeks. There may be energy loss and weakness for 1 to 3 months.
After the surgery, there is no way to tell whether you will or will not get pregnant until this occurs. This can be very frustrating. The average time for pregnancy is 6 to 14 months. Some women have taken 2 to 5 years while others are pregnant the first month. A repeat X-ray or laparoscopy can be used to check to see if the tubes stay open.
The risk of tubal pregnancy increases with the degree of tubal damage. With mild damage, the risk is about 1 in 20 pregnancies. With severe damage, it increases to 5 of every 6 pregnancies. Care must be taken in early pregnancy to identify tubal pregnancy promptly. Blood pregnancy tests and sonograms are needed at 2 to 3 weeks can see if the pregnancy is healthy. Early diagnosis increases the chance for medical treatment and avoiding surgery.
Expense can be a major obstacle. Most insurance companies do not cover tubal surgery. When there are reasons for associated surgery, insurance companies may cover that portion not related to the tubal surgery. On the other hand, some insurance companies will not cover any surgery if infertility surgery is part of the procedure. Written clarification on your insurance company's policy as it relates to your case may be needed.
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