TUBAL SURGERY FOR INFERTILITY, IS IT STILL AN OPTION?
Ali Nakash*
ABSTRACT
While tubal diseases are complex groups of conditions and diseases which can be either acquired or congenital, the vast majority are infective in origins and mostly are due to pelvic inflammatory conditions. Most of these patients with tubal conditions are currently being referred to IVF treatments. As increasing numbers of patient are currently cannot afford this kind of treatment, more attention should be paid to the alternative which is tubal surgery. A major hindrance to the success of tubal surgery is the many classifications of tubal diseases which can be confusing to both patients and clinicians. The two main investigations that are used to diagnose tubal disease( HSG and laparoscopy) cannot diagnose the real state of tubal health because both cannot see what is happening within the tubal lumen. A patent tube should not mean a healthy tube because the transport of the either of egg, sperm or embryo would need a healthy lumen which can secret enough nutrients and healthy cilia which can propel the gametes or the zygote. In my opinion this can explain the high failure rate of tubal surgery even in the hands of best surgeons.
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