IVF with Blocked Fallopian Tubes

[Geep]

Hi

Had an Hysterosalpingography (hsg) this morning and was advised that it looks like at least one, but probably both tubes will need removed. Likely cause it 2 eptopic pregnancies.

Due to the waiting lists, the dr today said it could easily be over a year before they get removed. I'm 36 and said i wouldn't do IVF after 38 (although can see that possibly changing), so don't really want to wait a year or even more to get tubes removed before i can try again. Just feel like any chance of another baby has been lost as by the time ill be fit to try again ill be to old.

The Dr advised that IVF is more successful when the damaged tubes are removed, but what im wondering is, can i go ahead with another round of IVF before having the damaged tubes removed? I've emailed my clinic to see if they will do it, but would be interested in hearing others opinions.

i have also contacted a private hospital to see if tube removal is something i can get down privately and if so, how much will it cost.

i don't know whether to hold on to some hope that it might happen for me, or move on and accept the fact that another child is not in my future.

Thanks

I'm no expert and haven't been at this IVF stuff for ages to know all ins and outs but from all the consultants I have spoke to blocked tubes do not affect IVF outcomes only if you have a hydrosalphinx which is a fluid filled and swollen (technical term is distended I think) tube. As that fluid is toxic. I believe these swollen tubes are more often than not likely to be seen on scans and as you had a HSG I imagine they would have seen this is suspected it. So if they are just blocked then I see no reason why IVF would not work for you. And I think you said you have had 2 ectopics so I would think you would have good chances with IVF.

Just to add that I'm of the opinion that of it doesn't affect the outcome or your decision such as going ahead with IVF. Then why do the surgery? To me it's a big toll and impact on the body and whilst it will give a clear answer and may be possible to clear tubes helpful for natural conception if your main concern right now is having the baby you could go private and see what happens, stay on NHS list for the surgery as it will take a year potentially and do that at a later date if you feel you want to.

I struggle to understand the push for a surgery that doesn't change your chances of success or next step decision. If you did have the hydrosalphinx it makes sense or suspected endo it makes sense to do it. Or if you feel you must know for certain what is going on then again that makes sense.

Anyway just my thought process and each person makes the decision that feels right for them. All the best to you!

If your tubes are blocked and also don't work then I would risk losing an an embryo to another ectopic. IVF actually increases your chance of an ectopic rather than decreasing it as effectively the embryo gets sucked back into and if the tube doesn't work there is no way of getting it back into the uterus x

@ivfgottwins that is interesting to know.

sorry my post should say *wouldn't risk

@Hoping4baby21 yes I only found this out after I lost my last tube after a second ruptured ectopic following IVF

Hi @Hoping4baby21 and @ivfgottwins. Thanks for your responses.

What I've been told so far is that the outcome of ivf is much better if damaged tubes are removed and clinic may not proceed with treatment until they are removed. And my worry is by the time I get them removed ill be 38 and not sure if that's to old to try ivf again. Have looked at going privately for removal but it could be £7000. And we already have a child and worry spending all our savings means we have less to spend on her.

We have one cycle left which we have already paid for. So wonder is it worth while trying that cycle with tubes still in place and if it doesn't work then move on and accept it wasn't to be

Not sure about anyone else but I'm really struggling with getting answers from Dr's. Not sure if it's cause we are between private and NHS or because of covid, but honestly I feel like I don't what to expect next. No one seems to really know whats going on or why I'm there and I feel like I'm the go between for the Dr's, I just keeping telling them what I've been told - really hope I haven't made mistakes. Everything just feels so disjointed. Even trying to get definite results of the hsg - not sure who is going to go through this with me. I have a review with private clinic in 3 weeks so hoping we can get a plan together then.

Ah sorry for the rant this turned into. Just some days are so frustrating

What I've been told so far is that the outcome of ivf is much better if damaged tubes are removed

Yes this is true as negative pressure caused by an IVF transfer often means the embryo is sucked back into the tubes and if it's damaged there is no way for the tube to move it back to the uterus

clinic may not proceed with treatment until they are removed.

I don't think a clinic would refuse to treat you - after all you are a paying patient so the only reason why they might not want to is the effect on their success ratings or because they genuinely believe you are at risk of losing an embryo to an ectopic. If it's the first one then they aren't a clinic I'd want to be treated by anyway

So have you had ectopics before? And were they from natural conception or IVF? A HSG isn't something routinely asked for by a private IVF clinic so lots of people continue with treatment never knowing if their tubes are blocked or not?

Thansk @ivfgottwins for explaing those things. I wasn't actually sure why there was a better success rate if damaged tubes were removed.

I've had 2 eptopics from natural conception. Neither got past 4 weeks. The first one happened a Yr after ttc. Was under the care of EPU and they never diagnosed an eptopic just a pregnancy of unknown location. They kept checking my bloods for 5 weeks or so until I got a negative test. We went for ivf treatment 8 months after this which was unfortunately unsuccessful. Approx 4 months later we got another positive test from a natural conception but I started bleeding. Again as I was still bleeding after 2 or 3 weeks and getting positive test I went to epu and on the initially 2 scans they didn't see anything (or nothing I was told about) but because my hcg levels were static I was rescanned again and then they noticed something in both tubes - they reckon the ongoing miscarriage and the one from the year before were eptopic.

So here we are. Feel like we are in limbo until we have our review.

I think my gut is to try ivf again even with damaged tubes in place, as its likely to be our last chance. It may reduce our chances of success but I don't think waiting another year or more to get the tubes removed either is an option.

I lost both my tubes to ectopics in the space of 18 month - and was infertile by age 36 - as awful as it was I actually felt relieved both tubes were gone - both ruptured and I nearly died twice and I felt like I was playing Russian roulette with my life every month I TTC - trying for baby shouldn't feel like a life or death gamble

I had twins via IVF the year after my second ectopic

@ivfgottwins my goodness, im so sorry to hear all that you have been through. that must have been very hard going through all that, but im glad the ivf worked for you. was that your first round of ivf?
I would be happy to have both my tubes removed as we were already on the IVF route, so in that sense its not a big shock. Its just the wait to have them removed, if i could go tomorrow to get them out then do another round of IVF id do it. But having to wait a year (or very possibly longer) before trying ivf again just worries me. I guess im worried about trying ivf at 38+ knowing the additional risk involved. However i also know that many women older than that have successful IVF pregnancies.

I think all i can do is wait until we have our review with the clinic and get a definite answer on the extent of tube damage and figure out what we do next.

I just had fallopian tube recanalization done in a hospital in Ireland and the radiologist removed both blockages and I've been given the go ahead to try conceive naturally. I was originally told 2 years ago ivf was the only way. I did had a bilateral proximal block (blockages at the entrance of both tubes but not the full tube) no liquid left my uterus at all and apparently my blockage is the most common. Mine wasn't hydro so maybe that's why they want to remove your tubes but you could try xxxx

Hello @Irishfaith I wonder if you could tell me where you had your tubal cannulation done, I can't find anywhere in the UK that are prepared to do it...I don't understand why if I'm willing to pay myself privately why no clinic wants to do it for me because I'm 39 and "IVF is a better way" I've done 2 rounds of IVF and both didn't make it and no embryos to freeze each round so it's costing me over 5 grand each try :(

Thank you for any advise in advance.

@Melodyloveschris I remember finding a place in London that would do it, although I never went. Can't remember the clinics name but I'm sure if you type in Tubal Cannulation or Fallopian Tube Recanalization London you will find it 😊! I had mine done in Dublin Connolly Hospital under a radiologist doctor. I'm pretty sure you have to be referred to him but you could always phone and enquire 😊! I'm really sorry ivf didn't work out for you 😭 I got pregnant twice after the tubal cannulation and lost both babies before the 12 weeks but thankfully I'm currently 25 weeks and all is okay, and I've absolutely that doctor who fixed my tubes to thank 🙏 I managed to avoid IVF because of him and my heart breaks for everyone still on the journey 😭 I really hope you get the procedure 🙏 xxx

Thank you for replying
I actually went to that place in London... Regency International
They were pretty rubbish and felt like they had no clue what they were doing
I've also had a laparoscopy but as it was on the NHS they didn't fix my blocked tubes, just confirmed they were and looked for any other issues but found none
I am so pleased for you
Hopefully your pregnancy is completely uneventful ❤️

The last round of IVF I had we got to 11 weeks only to find out we had a missed miscarriage at 7 and a half weeks
We had seen the heartbeat at 7 weeks
It was truly heartbreaking

I will have a look at that hospital and see if I can get a referral, not sure they would look at me because I'm 39 though

Good luck for the future Irish 😍

Oh @Melodyloveschris please don't let age worry you, although easier said than done. I really really hope the doctor sees you and looks after you. He's so lonely, a Canadian guy, if you want to private message me on Facebook "Abbie Cooney" then do and I'll give you his name. I just don't want to on this forum for his privacy. I'm very sorry for your loss, I know how hard they are xxx