Causes
There are many possible causes that can lead to a clogging of the fallopian tube and thus reduce the woman’s fertility. One possible cause of tubal conglutination is the increasing age of the woman. As the last spontaneous menstrual bleeding (menopause) causes a decrease in fluid secretion or an increase in viscosity of the fluid, the viscous secretion can cause the fallopian tubes to become sticky.
In addition, the number of cilia in the fallopian tubes decreases with increasing age of the woman. The consequences are poorer drainage of the fluid.In addition, a disease in which benign metastases of the uterine lining (endometrium) in the abdominal and pelvic area are formed can lead to the fallopian tubes becoming stuck together. This disease is called endometriosis and is a possible cause of infertility as a result of adhesions in the ovaries and fallopian tubes.
Another cause of fallopian tube adhesions is inflammation of the fallopian tubes (salpingitis), for example due to a chlamydial infection. This can affect one or both fallopian tubes. As a rule, germs from the vagina or uterus rise up the fallopian tubes (ascend) and can lead to inflammation through the spread of germs. Tubal inflammation can damage the cilia of the fallopian tube and scar the wall of the fallopian tube through inflammatory remodelling processes.
Diagnosis
There are several ways to check the patency of the fallopian tubes and thereby determine whether there is any adhesion of the fallopian tubes. One possible patency test is the so-called hystero-contrast salpingography (HKSG). In this procedure, a tube (catheter) is inserted into the uterus via the vagina.
The catheter is then fixed in place by a small liquid-filled balloon and contrast medium is injected, which can then be followed through the vagina by ultrasound (transvaginal sonography). Now the doctor can determine whether the contrast medium fluid flows into the fallopian tubes and whether these are continuous or stuck together. Another way of detecting a stuck fallopian tube is the so-called chromopertubation. In this procedure, a laparoscopy is performed to determine whether a blue dye solution (methylene blue, indigo carmine) introduced through the uterus either does not reach the fallopian tube at all (in this case, a narrowing (stenosis) or adhesions must be located at the beginning of the fallopian tube near the uterus) or flows out of the uterus into the fallopian tube, but does not leave it into the abdominal cavity (then there must be a constriction or adhesions on the part of the fallopian tube far from the uterus) or whether the blue fluid flows from the uterus through the fallopian tubes into the abdominal cavity (then the fallopian tube is continuous and everything is fine). These two methods of examination to determine whether the fallopian tubes are blocked are mainly used in women who are looking for the cause of their infertility.
