Fallopian Tubes
Fallopian Tubes
Picture a narrow passageway that''''s open to two-way traffic and ready for a lot of wild action, and you have the portrait of a healthy fallopian tube.
A pair of these tubes, each about three to four inches long, link the uterus and the ovaries and provide an environment where sperm and egg are welcome to meet. At the far end of each fallopian tube is a bunch of fingerlike projections called the fimbria that is draped over the ovary. When the ovary releases an egg, the egg is caught by the fimbria and then transported within the tube. The contractions of the tube and the tiny whipping projections of the tubal lining propel the egg on its downward journey. If that egg meets a sperm coming the other way--usually near the middle of the tube--well, that''''s where the action begins.
What happens after that depends on whether the egg is fertilized. If it is, the egg will travel from the tube into the uterus, where it implants into the uterine lining. But if the egg proceeds through the tube without encountering a sperm, it will disintegrate.
Dodging Damage
The health of the fallopian tubes--named in honor of the sixteenth-century Italian anatomist Gabriele Fallopio--is central to a woman''''s fertility. Damage to the fallopian tubes can interfere with this process. Most problems fall into the category of tubal occlusion next to or around the fimbria. Only 10 to 20 percent of tubal obstruction occurs within the fallopian tubes and next to the uterus, says Edmond Confino, M.D., associate professor and director of the In Vitro Fertilization Program at Northwestern University in Evanston, Illinois.
One type of obstruction is caused by pelvic adhesions. Bands of connective tissue attach to the surface of the ovary or form a barrier between the ovary and the fallopian tubes. These adhesions are sometimes the result of endometriosis, a disease where tissue similar to the lining of the uterus is located outside the uterus. Another cause of the adhesions is pelvic inflammatory disease (PID), a condition of the female pelvic organs that''''s often caused by sexually transmitted diseases (STDs) such as gonorrhea and chlamydia. Both endometriosis and infections like PID can also block tubes at their connection to the uterus.
The fallopian tubes can become obstructed if the fimbriae are damaged, says Dr. Confino. Occasionally, a blockage within the tube is created by microplugs--small masses of proteinlike tissue that form inside the tubes.
Keeping Them Clear
How can you protect your fallopian tubes and safeguard your fertility? Here''''s what experts recommend.
Give the red light to PID. Since significant tubal damage is caused by PID, and PID is often transmitted sexually, you should take every precaution to practice safe sex. In other words, be sure to use a condom--and use it the right way--if there''''s any chance that your partner could have a sexually transmitted disease.
Think twice about douching. Studies indicate that women who douche may increase their risk of PID. In fact, douching may actually cause infection to travel into the upper reproductive tract and fallopian tubes. So experts advise against the practice.
| Out-of-Place Pregnancies Ectopic pregnancies are on the rise. But there''''s still good news: Treatment is improving all the time. An ectopic pregnancy, such as a tubal pregnancy, occurs when a fertilized egg implants itself somewhere other than in the uterus. While ectopic pregnancies can occur on the ovary, cervix or even in the abdomen, nearly all occur in the fallopian tubes. Fewer than 2 out of every 100 pregnancies are ectopic. But experts estimate that the incidence has increased two-to threefold over the past 20 years. In a tubal pregnancy--because of damage to the fallopian tubes or other reasons--the fertilized egg doesn''''t migrate to the uterus. Instead, it remains trapped in the fallopian tube. When this happens, a woman usually shows some of the signs of pregnancy--including a delayed or abnormal menstrual period--and she may experience abdominal pain, says Edmond Confino, M.D., associate professor and director of the In Vitro Fertilization Program at Northwestern University in Evanston, Illinois. Any woman with these signs should see her doctor immediately, he says. The best way to help prevent an ectopic pregnancy is to avoid sexually transmitted diseases and pelvic inflamatory disease by practicing safe sex: Avoid multiple partners and use barrier contraceptive methods, experts say. But if you do have an ectopic pregnancy, you should be seen as soon as possible by a gynecologist, says Dr. Confino. Left untreated, an ectopic pregnancy can be potentially dangerous. Abdominal surgery used to be necessary to open the fallopian tubes and remove the pregnancy. Now, doctors can often do it with laparoscopy, a less invasive surgery. Women can also be treated with medications that dissolve the ectopic pregnancy in some patients, according to Dr. Confino In a tubal ectopic pregnancy,
the embryo is implanted in the wall
of a fallopian tube rather than the uterus.
 . |
Pay attention to changes. If you experience pelvic pain, with or without a fever, see your doctor. It may be a sign of either PID or endometriosis.
Quit smoking. There appears to be some connection between smoking and the development of PID and premature menopause, studies show. If you''''re a smoker now, it''''s just one more reason why you should try to kick the habit.
See also Fertility, Ovaries, Pregnancy, Reproductive System, Sexually Transmitted Diseases
