Tubal disease affects approximately 25 per cent of infertile couples, and varies widely, ranging from mild adhesions to complete tubal blockage. Treatment for tubal disease is commonly surgery and, owing to improvement in microsurgery and laser technology, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30 per cent with certain procedures having success rates up to 65 per cent. The development in IVF has now made it a suitable alternative to tubal surgery.
The main causes of tubal damage include:
Bacterial and viral infections
They are usually sexually transmitted infections, such as syphilis, chlamydia and gonorrhoea, which often result in scarring. A specific example is hydrosalpnix, a condition in which the fallopian tube is occluded at both ends and fluid collects in the tube.
A patient with hydrosalpnix going through IVF will experience difficulty conceiving because the fluid that is produced can damage the embryo.
The most common are appendicitis and colitis (inflammation of the colon), high fever as in malaria. Abdominal diseases cause inflammation of the abdominal cavity, which can affect the fallopian tubes and lead to scarring and blockage.
Previous surgical operations are also causes of tubal disease and damage. Pelvic or abdominal surgery, such as appendectomy for someone with appendicitis can result in adhesions that alter the tubes in such a way that those eggs cannot travel through them.
An ectopic pregnancy is a potentially life-threatening condition that occurs in the tube itself. Even if carefully and successfully overcome, it may cause tubal damage
In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.
Approximately 10 per cent of infertile couples are affected by endometriosis. Endometriosis affects five million women in the US and six or seven per cent of all females. It has been linked to late marriage due to prior occupation with the busy schedule of work by these women, who delay having children till the late mid 30s or early 40s. In fact, 30-40 per cent of patients with endometriosis are infertile. This is two to three times the rate of infertility in the general population. For women with endometriosis, the monthly fecundity (chance of getting pregnant) diminishes by 12 to 36 per cent.
This condition is characterised by excessive growth of the lining of the uterus, called the endometrium. Growth occurs not only in the uterus but also elsewhere in the abdomen, such as in the fallopian tubes, ovaries and the pelvic peritoneum.
Symptoms often associated with endometriosis include heavy, painful and long menstrual periods, urinary urgency, rectal bleeding and premenstrual spotting. Sometimes, however, there are no symptoms at all, owing to the fact that there is no correlation between the extent of the disease and the severity of the symptoms.
The long term cumulative pregnancy rates are normal in patients with minimal endometriosis and normal anatomy. Current studies demonstrate that pregnancy rates are not improved by treating minimal endometriosis.
Abnormalities of the female reproductive organ
At least 10 per cent of all cases of female infertility are caused by an abnormal uterus. Conditions, such as fibroid, polyps, and adenomyosis(over enlargement of the endometrium), may lead to obstruction of the uterus and Fallopian tubes. Also, congenital abnormalities, such as septate uteru (a double cavity uterus), may lead to recurrent miscarriages or the inability to conceive.
Approximately three per cent of couples face infertility due to problems with the female cervical mucus. The mucus needs to be of a certain consistency and available in adequate amount for sperm to swim easily within it. The most common reason for abnormal cervical mucus is a hormone imbalance, namely too little estrogen or too much progesterone.
It is well-known that certain personal habits and lifestyle factors impact health. Many of these factors may limit a couple’s ability to conceive. Fortunately, many of these variables can be regulated to increase the chances of conception and one’s overall health.
Diet and exercise
Optimal reproductive functioning requires both proper diet and appropriate levels of exercise. Women who are significantly overweight or underweight may have difficulty becoming pregnant. We have been able to assist a significant number of patients to get pregnant ordinarily or following filed IVF cycle by getting them to go through a Mayr therapy and losing between 10 and 15kg in 10 days.
Drugs, such as marijuana and anabolic steroids, may impact on sperm count in men. Cocaine use in pregnant women may cause severe retardation and kidney problems in the baby. It is, perhaps, the worst possible drug to abuse during pregnancy. Recreational drug use should be avoided when trying to conceive and during pregnancy.
Environmental and occupational factors
The ability to conceive may be affected by exposure to various toxins or chemicals in the workplace or the surrounding environment. Substances that can cause mutations, birth defects, abortions, infertility or sterility are called reproductive toxins.