Data were examined on 5124 women between the ages of 15 and 45 years from the Quebec Pregnancy Registry who had clinically verified miscarriages between the years 1998 and 2003. A total of 10 matched control patients were also randomly selected for each case.

The investigators found that of the women who miscarried, 5.5% (284/5124) had taken antidepressants during their pregnancy compared with 2.7% (of 51,240) of the matched control patients.

After adjusting for potential confounders, “antidepressant use during pregnancy was found to be associated with an increased risk of spontaneous abortion compared to those with no use” the study authors wrote.

In addition, SSRIs used alone, SNRIs used alone, and a mix of antidepressants from different classes used together were also associated with an increased risk for spontaneous miscarriage.

When the investigators compared type of antidepressant used vs not used, they found that paroxetine alone and venlafaxine alone were both significantly linked to an increased risk for miscarriage.

Source: http://cme.medscape.com/viewarticle/723297?src=cmenews&uac=123618HT

Diagnosis

Fallopian tube obstruction can be diagnosed in a number of ways.  Laparsocopy is a surgical procedure which uses a small lighted tube that is inserted through a tiny incision (cut) on the abdomen.  With this procedure, a surgeon is able to see directly into the abdominal cavity and check the state of the fallopian tubes on the outside and the inside by injecting colored dye through the cervix and watching for its appearance at the end of the tube.

Hysterosalpingogram is a procedure in which a dye is injected into the uterus and the uterus is examined via X ray to see if the dye spills into the tubes and pelvic cavity.  These diagnostic techniques are quite invasive so they are not done routinely unless a woman has been trying to conceive for a long period of time without  success (and male factor infertility has been ruled out).

Causes

The common reason for the fallopian tube blockage is a pelvic infection which may produce minor symptoms or no symptoms at all.  However, if the infection was left untreated it can cause scarring, adhesions and complete obstruction of one or both tubes.  In cases of PID (pelvic inflammatory disease), opportunistic bacteria coming from the uterus can spread to the fallopian tubes since they are the structures closest to the uterus.  If a woman is experiencing acute infection, antibiotic therapy is indicated in order to prevent damage to the fallopian tubes.  However, if a woman already has obstruction and damage of the fallopian tubes, a surgery that can repair the damage may be indicated.

Endometriosis can be another possible cause for fallopian tube obstruction.

It’s also possible that fallopian tubes are blocked only some of the time.  This type of blockage is referred to as a “functional blockage”.  This scenario is typical in women who experience a lot of stress.  Stress tends to constrict pelvic musculature and decrease blood flow and this can be a factor in inability to conceive.  This type of functional blockage responds very well to acupuncture as well as Chinese herbal medicine.   Also, excessive mucous buildup within the tube can create a plug and cause blockage.  In Chinese medicine, this would be refered to as “damp accumulation” and would be treated through dietary therapy, herbs and acupuncture.

Infertility Treatment for Blocked Fallopian Tubes

If there is an extensive damage and scarring in both fallopian tubes  it is very difficult (or nearly impossible) for a woman to conceive and IVF is probably the best route to take.  IVF was actually developed for women with extensive fallopian tube obstruction and damage since it can bypass the problem.

Using acupuncture prior to an IVF treatment is a wise decision since  it can help decrease side effects of drugs, decrease stress levels and remove any stagnant blood and energy in order to ensure successful implantation.

Microsurgery is another treatment option for women whose tubes are not damaged along too much of their length.  Surgery seems to be more effective if the damage is in the area closer to the uterus.

The good news is that modern technology does help women with tubal blockage have a healthy pregnancy and birth. If you decide to use assisted reproductive technology, you should make an effort to take good care of yourself in order to create optimal conditions for a new life to flourish. Nutritious diet, proper rest, moderate exercise and stress reduction are the most important things that you can do to improve your health as well as increase your chances of conception.

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