What is the difference between IVF and tubal cannulation?
Intro Vitro Fertilization (IVF) is an assisted reproductive therapy that can increase your chance of pregnancy. IVF involves a series of procedures recommended according to your infertility problem.
Tubal cannulation is a surgical procedure that removes blockages from the fallopian tubes, which can cause difficulty in conceiving. The uterus and ovaries are connected by the fallopian tubes and are where the sperm meets the egg for fertilization.
Blocked fallopian tubes are common and account for approximately 25-30% of infertility problems in women.
Symptoms and Diagnosis of Tubal Blockage
It is uncommon for women with tubal blockage to experience any symptoms. However, the most significant signs are infertility and pelvic inflammatory disease, like chronic lower abdominal pain.
If you find yourself experiencing problems trying to conceive or severe lower abdominal pain that persists, some tests can determine if a blockage is a cause.
- Hysterosalpingogram (HSG) – This is an x-ray where the procedure involves passing a dye through the cervix into the uterus. The dye can help to identify any location with a blockage.
- Laparoscopy – This is a minimally invasive surgical procedure performed with a laparoscope. A small hole is made above the belly button for the laparoscope to enter and search for any blockages in the fallopian tubes.
Surgical and Non-Surgical Treatment to Treat Blocked Fallopian Tubes
- Tubal Cannulation – Tubal cannulation is done by inserting a catheter with a balloon attached to the end, into the fallopian tubes. This procedure is commonly considered when the blockage is located near the uterus.
- Tubal Reanastamosis – This procedure removes part of the fallopian tube damaged by disease or blockage. The two healthy sections of the tube are then joined together. Tubal reanastamosis is also done to reverse tubal ligation, which is when the tubes are tied or cut to prevent pregnancy.
- Salpingectomy – A salpingectomy is used to treat hydrosalpinx (build-up of fluid in the fallopian tubes) before IVF treatment to improve pregnancy chances by removing the part of the tube affected.
- Salpingostomy – This procedure is considered when hydrosalpinx is found at the end of the fallopian tube. A new opening is created in the tube close to the ovaries. However, this procedure can cause scarring later on.
- Fimbrioplasty – This is a laparoscopic procedure used to rebuild the finger-like ends of the fallopian tubes by joining them back together. These ends are called fimbriae and are found near the ovaries.
The risks that can occur post-surgery to treat fallopian blockage are:
Successful tubal cannulation can increase your chances of getting pregnant naturally. Some couples may consider IVF treatment to help with natural conception. However, there are a few things to think about before considering which treatment is right for you.
IVF treatment is expensive, and you may need more than one cycle to conceive successfully. IVF treatment can also lead to multiple births or ovarian hyperstimulation syndrome when ovaries can become swollen from hormone medication and injections.
When to consider tubal surgery:
- If there is an obstruction in either or both fallopian tubes, the type of procedure involved can be decided depending on several factors like location. More than one procedure may be suggested as well.
- If there is a history of blockage that is causing infertility.
- To treat hydrosalpinx, which is fluid build-up in a part of the tube.
- To reverse tubal ligation, which is when the tubes have been tied or cut to prevent pregnancy.
When to consider IVF treatment:
- If male infertility is an issue, like low sperm count.
- If the cause of female infertility is polycystic ovary syndrome (PCOS) or endometriosis.
- Age >34 years
- If there is more than one cause for infertility, for example, age and PCOS, or tubal blockage with low sperm count.
- If there is a mild tubal blockage or tubes look unhealthy and can unlikely be corrected by surgery
- Previous history of open surgery or prior laparoscopy for tuboplasty
- When quicker treatment results are desired
Comparing IVF and Tubal Cannulation Success Rates
Success rates are more favorable for IVF treatment, with 60-65% per cycle. Tubal surgery success rates are approximately 60-70% for correcting tubal blockages but 25-35% for pregnancy success. But the success rates highly depend on location and type of blockage. Tubal proximal occlusion and mild distal blocks have higher success rates post-surgery. Although surgery can remove blockages, the functionality of the tubes can only be determined by pregnancy.