Severely blocked fellopian tubes and pregnancy

[kcarey77]

I had an HSG done last year that showed my tubes were open (dye came out ends) so I went on to a diagnostic laparoscopy with chrommotubation last week to check for endometriosis or any other disease preventing my husband and I from coneiving our first child after 3 years of desperately trying.
My doctor told me both tubes were blocked and he opened them slightly with a laser but they will not remain open. He said the only choices we had were abdominal surgery to "fillet" my tubes and open them up or IVF. Insurance will not cover either option. If we TTC while they are slightly open our chances of an eptopic preganncy is greater than 50%.
I desperately wanted to be the large percent of people that had a laparoscopy and got pregnant months after, but this is not my case. He said we will have a very difficult time achieving pregnancy. We are so upset at weighing our options, but was looking for similiar situations out there first.
Has anyone had both tubes blocked (distal end) and had a successful pregnancy? Whether with IVF or tubal surgery?

 

[Anne24]

I have heard hydrotubation is an option and a good option.There's a 68% chance of unblocking the tubes with this process. I too have been diagnosed with two blocked tubes-one proximal and the other showed no spillage. I am seeing a FS day after tomorrow to know about my chances of opening the tubes.Wonder if you can suggest hydrotubation to your doctor?

 

[kcarey77]

Thanks so much a reply! I know fimrioblasty is an option (I watched the procedure done on YouTube) and its pretty basic. My OBGYN said he could not do the surgery laparoscopically and I know it can be done. I am changing both my OBGYN and my RE in March. I really think he could have done more during my last surgery, perhaps he just wasn't qualified or experienced enough. I have heard good and bad with the hydrotubation. Surgery to open tubes in general can create scar tissue and lower chances. At my age, he said not to bother with surgery . I didn't want to hear that because I just turned 34 and I have friends in their late 30's having healthy babies!
How did you find out your tubes were blocked? And HSG or laparoscopy? An HSG is not very accurate (40% misdiagnosis for blocked tubes due to spasms). I would love to stay in contact through this emotional journey with you. I'm not finding many people with 2 blocked tubes and successful pregnancy after. I wish you well and baby dust to you!

 

[Anne24]

Hey WE can always stay in touch with each other hun. You can always PM me here WE can at least share each other's problem. I had an HSG to show my blocked tubes I asked my FS about chances of the report being incorrect and he said that a proximal/cornual block can be incorrect due to tubes going in spasm but a fimbrial block is mostly correct since the dye showed no spillage in my right tube. The doc suggests lap but before that I need to go for two more tests, whose report, if good, then we proceed with lap. Since I have no history of previous miscarriage or abortion or any disease, so he wants to check if I have tuberculosis of the uterus(kind of an infection that can lead to blocked tubes). These two tests would come up with the results and if the results are not good, it would take another 6months time to cure the TB and then lap(may be) My FS blatantly told me that its gonna be a long battle,so dont expect any quick fix remedy

 

[Lawyer chick]

Hi Hun. I have blocked tubes. I'm waiting on my lap. I haven't much about surgery in Ontario to unblock tubes partly cause our govt insurance pays some of I've costs for 3 cycles. I wish you good luck you find an option to make it work.

 

[LillyLove]

kcarey-

My tubes are blocked at the distal ends. I am 36 and I am having laparoscopic fimbrioplasty at the end of March. That video on youtube that you saw (dr. carlos rotman, chicago, il) I actually called their office and almost set up the appointment until at the last minute I found someone to do it here. I live in Minnesota. With my original obgyn (the one who did the hsg and discovered the tubes) she just wanted to make little slits at the end of the tubes (they would close right back up!) and I just knew that I needed to find a specialist. Good luck! I hope it works for us. We are giving ourselves 6 months before moving on to ivf.

 

[LillyLove]

PS: When I went to set up my FMLA medical leave through work for the surgery the operator on the phone actually had the proceedure done and has 3 children to show for it. What a coincidence, and proof that it can work.

 

[kcarey77]

WOW! I'm feeling so much better now! I went back to my OBGYN and asked for a copy of the surgical report (photos and all) and I know he did what he could during my laparoscopy, but you're correct Lillylove, they will close back up! The question is, how soon? No one can answer that and it concerns me. My husband and I are trying for the first time since my lapro the next 2 weeks and are hopeful we get a BFP soon. I hate to think that I need Fimbrioplasty surgery. I cant afford it. Thankfully my tubes are not hydrosalpinx, so I can keep them for now. I've heard good and bad reports on tubal surgery. Once day I eliminate it completely from my plan and the next, Im ready to try it. Each situation is unique and with IVF being so easy, a lot of surgeons are not experienced enough to perform tubal surgery and they are SO delicate. If the ciliae in the tubes are disturbed, your chances of conception are very low. I need an expert.
I'm so HAPPY to have others to talk to about this and share hope and positive thoughts.

Lillylove- PLEASE keep me updated on the outcome of your laparoscopy, I will keep you in my thoughts. My OBGYN said in order for fimbrioplasty to be successful, he must cut into the abdomen and "fillet" the tubes properly so they stay open. The ends of my tubes look like wilted flowers (covered in blisters almost) and they need to be surgically tuned into a flower blossom again. I live in Florida and Infertility is weak here cause most insurance does not cover it so most RE's starve. I have an appointment with one of the best RE's in the Nation this month for 2nd opinion on what I should do next. Im hopeful she will help me.

Anne24- I would LOVE to keep in contact. It's a struggle knowing we have a huge obstacle to overcome, but it is possible. Definitely go for the laparoscopy! I know several people that had it and became pregnant after years of trying during the first 3 months! Im staying positive that we could be pregnant in the next 6 months. Because I was diagnosed with "Unexplained Infertility" for so many years, I feel like I wasted precious time by not really knowing what was wrong inside me (blocked tubes). I went based off an HSG that was very incorrect. Any adivse I could give to you is go straight to the lap, it will give you peace of mind in the end and hopefully result in a BFP

Lawyerchick- I wish you the best on your results and I hope you get your BFP soon!

 

[kcarey77]

Lillylove, if you dont mind me asking, how much is the fimbrioplasty going to cost? Does your insurance cover it? That is the deciding factor for my plan B. Thanks!

 

[LillyLove]

KC- Apparently the surgeon is billing it as a laparoscopic salpingostomy but will do fimbrioplasty once he is in there. The way he is billing it, it will be covered by insurance. I asked him if there were any indicators as to "who's tubes close up after the surgery, and who's don't" and he said he can make the generalization based on the amount of adhesions he sees once he is in there. I also asked him how long they stay open and he said most close in 3 months if they are going to close, but if the surgery is successful most of his patients get pregnant within 6 months. (Hence, why we are giving it 6 moths before going to ivf).

The thing is my our insurance does NOT cover IUI which is really expensive with all of the monitoring etc ($2,000 a cycle) which would really cut into our ivf budget. I am struggling whether we should just try natural or spend the money on iui.

Let's keep this thread alive, so if we do get our bfps we can give hope to others with the same tubal issues

 

[LillyLove]

To be specific the fimbrioplasty is $8-9,000 but with insurance coverage it will be $1600.

 

[kcarey77]

My OBGYN billed my diagnostic Laparoscopy and Chromotubation as "Pelvic Pain" so I only had to pay 20% of $10,000. Maybe I should ask my RE is she could bill it as another lap? That's genius! I asked my OBGYN if he would do the fimbrioplasty laproscopically and he said he could, but it would not be done correctly, meaning, the tubes could close back up. He needed to get in there and really open them up permanently. I suppose it comes down to the surgeon and how experienced they are with the surgery.

IUI is expensive, and according to my OBGYN a big waste of money for women with occluded tubes. Your chances are slim. If you had endometriosis or something, maybe, but not blocked tubes. He also said no fertility drugs will help (I asked for clomid again). I tried clomid 100 mg for 4 cycles last year and all I got was ovulation pains and a nasty attitude. It made me very emotional and served no purpose what-so-ever.

I agree we should keep this thread alive! There seems to be very few of us TTC with blocked tubes. I know it can happen for us, and Im hopeful it will! I'm happy to share my experiences (I feel like I've done it all..lol) with anyone who cares to hear them.

I'm just glad we now have an answer as to why we have never had a BFP. I knew something was wrong with me in my 20's because I have always been in long term relationships and never been on birth control, and never even had a scare of being pregnant.

PS- My OBYGN also told me to get another HSG after 3 mth of my lapro to check and see if they were still open. I told him he was insane if he thought I would put myself through that horrific test again which led to INCORRECT results. More wasted time, money, and energy I will never get back.

Keep me posted on your surgery, I will keep you in my thoughts and prayers!

I got a HIGH on my clearblue easy fertility monitor this morning so DH and I will be going for it the next week in hopes of being successful.

 

[LillyLove]

Awesome article to give us hope!!
https://findarticles.com/p/articles/mi_m0CYD/is_9_35/ai_62981792/

The article basically says that tubal surgery is better than ivf in most cases with fimbrioplasty having a 78% pregnancy rate within a year! It also states that most doctors today aren't bothering to learn these surgical techniques and are just pushing people to ivf unnecessarily.

My surgery is on Tuesday and this article gives me some hope as I have been so down and doubtful the last week.

 

[LillyLove]

Hope you liked the article. PS.....I think you should look for a Gynecological Surgeon in your area that is a specialist. After doing more research and talking to my surgeon he said fimbrioplasty should ONLY be done laparoscopically and that you should seek a specialist who does them frequently.

On the other side, I am getting super nervous that my insurance isn't going to cover it for some reason. I called them and they said they said they don't cover infertility "repair" but my doc said he wasn't billing it as that.. He is using Insurance cpt code: 58673 with 614.1 hydrosalpinx and 614.7 pelvic adhesions.

Hope this helps.

 

[kcarey77]

Thank you so much for the article! Very informative

If your Doctor is billing it as something outside of infertility, you will be fine. My insurance was covering my cloimd and didn't even know it cause it was a "generic" drug. They are trained to tell you what your insurance will and will not cover. Your Dr. knows how to get around it, trust me, he wants to get paid...LOL! I think you're in good hands with your specialist and I'm so happy for you!
I have heard good things about the surgery as well, but you're correct, most surgeons don't bother with learning this skill anymore cause IVF is so popular. A trained professional in tubal surgery is a MUST! What state do you live in? How did you find a specialist in your area? If I call around everyone is going to tell me they "specialize in tubal surgery" although they only performed maybe a dozen fimbrioplastys.
I will be getting a new RE soon and I'm going to ask that she recommend a specialist in that field to do my surgery. I can't afford to miss a month of work. I'm in new home sales and if I don't work, I don't get paid. I must have another laparoscopy.
I was really hoping for a miracle last month but AF got me on Monday so we will try again this cycle and hope for that BFP.

I will keep you in my thoughts and prayers for a successful operation on Tuesday! I'd love to hear all about it and any updates you have. If I can get my insurance to cover it, I'm definitely going for it!

 

[LillyLove]

I'm in Minnesota....Here is where I found my doctor: www.mngyn.com They are actually surgeons that specialize in gynecological disorders. I basically found them from searching the internet and then I went in for an hour long consultation with the doctor I chose. Before choose from their doctors, I googled the different surgeons name and the one I chose I was because my search brought up his name under all these seminars and conferences about tubal surgery. (I'm such a spy!) I went to my consultation with him with a list of questions about the procedure and what his thoughts were about going to straight to ivf. He was very objective and a great listener and answered all my questions thoroughly. I guess at this point I will just have to put my faith in his hands and God and pray it works. We are going to give it 6 months before moving on to ivf even though it says give it a year. (I am 36). Thanks for your thoughts and good wishes. They said I could go back to work in 4 days...but I am taking a week off to rest and heal.

 

[LillyLove]

* sorry for all the typos! Typing from my blackberry!

 

[kcarey77]

I did some research online and found the top doctors for 2011-2012 in Orlando and my new RE is on the list! Now, I just need a day off to get in and see her and see what her thoughts are on the surgery and who she could refer to do it. I'm not sure insurance would pay for a procedure done by a Reproductive Endocrinologist, an OBGYN looks less "suspicious"
Best of luck to you! Thanks so much for sharing your research with me. It's very helpful to speak to someone in my situation and bounce ideas off of one another.

 

[LillyLove]

I bet your RE will have great suggestions and recommendations for surgeons. My surgeon actually gets referrals from the IVF clinic that we will be moving onto if the surgery doesn't work. Uggg....can't even think about that now!

I will check back here after surgery - probably Wednesday and give you a full report. I love having someone to talk to about this too. Hopefully we will be bump buddies soon!

 

[kcarey77]

I will keep you in my thoughts and prayers for a SUPER successful surgery and a BFP coming very soon for you!!