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Monday, 20 January 2014

Role of tubes in conception

The fallopian tubes are two narrow tubes or ducts whose function is to enable an egg released from ovary to reach the uterus. It would be erroneous and simplistic to think of tubes like hose pipes and presume that as long as the tubes are 'open', all is well! 

The end of the tubes have delicate fringe-like structures (called fimbria) which enables the tube to 'pick up' the egg on ovulation. The tube has muscle fibres in its wall and the inside of the tube has two types of cells, those that give out secretions to keep the sperms, egg and the embryo alive; and cells with hair like structures called cilia. Secretions from the cells lining the tube create an environment where sperms can interact with the egg and form embryo. The embryo so formed is nurtured in the tube while being eased towards the cavity of the uterus by the fourth day of its life at which time it is ready to implant. Rhythmic muscular contractions of the tube and the swaying motions of the cilia enable the movement of the egg and embryo.

Tubes thus have a very important and delicate role to play and it is just not enough for the tubes to be 'open'. Unfortunately, it is not possible to assess the inside of the tube, all that is normally done is to check for patency and if a laparoscopy (keyhole surgery) is done, the outside of the tube and the fimbria can be assessed. 

If the tube is damaged, then it may not be able to transport the embryo to the uterus and the pregnancy may settle in the tube. This condition is called ectopic pregnancy and unless dealt with appropriately can be life-threatening.  If there are any indications that one  or both of the tubes may be damaged, it is best to keep trial of treatments other than IVF short, lest precious time is lost along concomitant decline in fertility.

Do not despair....There is always a way.


How does pregnancy settle in the uterus in the next post......

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