Question: I have been trying to get pregnant for the past four to 6 years now..two years ago the gynae told me i have blocked Fallopian tubes when I did HSG examination, they told me they can unblock my tubes through surgery or I can conceive through IVF.. I DON’T HAVE SO MUCH money for those procedures, question: Can I use Clomid in the mean time I’m saving money?? My gynae said I have healthy eggs.
Answer: Unfortunately the only way for your eggs to reach your uterus is through the Fallopian Tubes, the egg is also fertilized while in the Fallopian tubes, from there the fertilized egg moves down into your uterus to embed into the lining. Using Clomid would not make a difference at all. Having your tubes unblocked through surgery isn’t always successful. Fallopian tubes are very sensitive and damage to them is often irreversible. Your best option would be IVF, if your eggs are healthy that will give you a very good chance at success with IVF. ** Please note the medical disclaimer at the bottom of the page
What causes my Fallopian tubes to be blocked: There are a few causes, one of them is infection, if at any stage in your life you had a pelvic infection of Pelvic Inflammatory Disease or PID, you could be at risk for blocked Fallopian tubes. Other causes are: – Current or historical STD (Sexually transmitted disease) especially Chlamydia or Gonorrhea – Previous ectopic pregnancy – Ruptured appendix – History of abdominal surgery – Infection caused by abortion or previous miscarriages
Why can’t I fall pregnant when both my tubes are blocked? When you ovulate, an egg is released from your ovaries directly into one of your Fallopian tubes, while there it awaits the arrival of sperm to fertilize it. If the egg is not fertilized, it moves down to your uterus and gets expelled when you menstruate. If it is successfully fertilized the fertilized egg will move down your Fallopian tube into your uterus where it embeds into your endometrial lining and the baby grows. If your tubes are blocked, the egg cannot be fertilized by sperm and it cannot move down into your uterus. Sometimes your tubes can be partially blocked, and this can be a very big risk for an ectopic pregnancy, which is life threatening and can cause massive internal bleeding. If at any stage during the early stages of pregnancy you feel extreme abdominal pain, with or without shoulder pain you need to seek medical care immediately.
How are blocked Fallopian tubes diagnosed? Your doctor will most probably send you for a HSG X-ray or Hysterosalpingogram is a radiologic procedure. It entails the injection of a dye into your uterus through your cervix. X-rays are then taken to see the shape of your uterus and the state of your Fallopian tubes. The procedure can be very painful but it will be over in seconds. You may want to take a couple of pain tablets an hour before the procedure if you’re nervous about the pain and you will need a sanitary towel afterwards as there will probably be some bleeding afterwards. Your doctor will most probably also prescribe an antibiotic to take afterwards to prevent any risk of infection.
What are my options? One of the most difficult parts of answering emails relating to blocked Fallopian tubes is breaking the news as gently as I possibly can that your options are limited. You have some choices, but depending on your financial situation it might not be ideal.
1. Surgical repair. This should ideally be done by a Fertility Specialist or an excellent Gynecologist. Unfortunately the repair is not covered by Medical Aid and you will have to foot the whole bill, including hospital stay, theater fees and anesthetist among other things. The other drawback is that depending on the damage to your Fallopian tubes, the operation might not be successful. The cost for repair is roughly the same as one IVF attempt. If there are no other fertility issues, your eggs are healthy and there is no male infertility factors then you could be successful with one IVF attempt. But as with anything and everything conception related there are no guarantees. Most clinics will state that it can take up to 3 IVF attempts to conceive. I’ve known a few women who’ve done 10 or more. But those are the exception.
2. IVF. or In Vitro Fertilisation, is a good option. Unfortunately it is extremely expensive and cost prohibitive for the majority of couples in South Africa. I have written an article on cost effective treatments here, but not all of them will help with blocked tubes. In this case you may only be able to go through one of the State hospitals on the list, and even then, there will be costs involved, but not as much as private clinics.
3. Adoption. If all else fails you might consider adopting a baby. Adoption has brought many families together, but it’s also not for everyone. You may want to research this option thoroughly and read books written by adoptees and birth mothers. Being armed with all the necessary information regarding adoption will go a long way in helping you understand and assisting your adopted child as he or she navigates through life.
4. Living Child Free: I will be honest, when I first struggled to conceive and especially after my 1st miscarriage I would have died thinking I was going to go through life child free, it simply wasn’t an option. The only reason I’m putting this as an option is to let you know, you are not alone, you will not die and there might be light at the end of the tunnel. I struggled with this choice, I really did, but I’d made a promise to myself that if I’m not pregnant by 39, that I will completely stop trying. My husband and I spoke about adoption at length, and we have seen many of our friends adopt and all of them had happy outcomes, but we just felt it wasn’t the way for us. So set out coming to terms with living child free. It’s been 5 years now, and I still struggle with our decision. It wasn’t an easy road. I just kept repeating to myself and anyone within earshot or who asked whether we have children or not, that we are OK, I repeatedly said we have accepted it, that we are enjoying life, we are enjoying the silence and the freedom, that I am over my infertility trauma, we have moved on. Not because I was lying but that I was affirming what I knew would eventually be true. It didn’t necessarily feel true, but in the logical sense it was true. Slowly but surely we established ourselves as a childless couple, we enjoyed the freedom and the quietness. We enjoyed each other and our relationship has blossomed. For the most part we are REALLY enjoying ourselves, sleeping in, going out to dinner at the drop of a hat, saving money and going on holiday without the need for a trailer but there are moments, and there will always be moments of extreme sadness, loss and missing out on the fun things, the achievements, the milestones.
So, if you’re reading this and you’re grappling with the decision of staying childless, or opting for adoption or even for saving up for your 1st IVF, I hope this has in some small way helped you to come to terms with your decision.