Testing & Diagnostics
Medically reviewed by Norbert Gleicher, MD, FACOG, FACS - Written by CHR Staff - Updated on Nov 15, 2014
Tubal Perfusion Pressure (TPP)
Sometimes, even when a fallopian tube is unobstructed, the tube does not function very well. Most people, including many physicians, think of fallopian tubes as simple pipes where egg and sperm meet, and as passageways for the fertilized egg to reach the uterus. However, in actuality, a fallopian tube is a much more dynamic organ. At the end of a fallopian tube closest to the ovaries, there is a part called the fimbriae. Fimbriae are very delicate skin-like folds, which "grab" the ovulated eggs from the ovary with gentle, sweeping motions. When this function is compromised, even a seemingly "open" fallopian tube can no longer serve its purpose. Therefore, even open tubes can be diseased. The most frequent condition affecting fimbriae, causing their agglutination, is endometriosis.
"CHR demonstrated that women with high TPP measurements are more likely to have endometriosis."
With the use of specialized computer software, pressure transducers, and selective salpingography, we have the capability to more accurately measure the functions of fallopian tubes.
This is done by measuring pressures during selective salpingography. Tubes that are rigid and diseased need higher pressures to move the dye through, whereas normal tubes require only minimal pressures.
Does this matter? We believe so! In a 1995 study, we demonstrated that women with high TPP measurements are more likely to have endometriosis than women with low pressures. More importantly, women with high TPP measurements take longer to become pregnant and do not achieve pregnancy as often as women with low TPP measurements. TPP measurements have since become part of infertility diagnosis at many respected fertility centers.
CHR physicians have used the information from SS/TPP measurements to recommend that women use IVF to achieve pregnancy, rather than continue trying to conceive using methods that rely on their fallopian tubes. Because IVF circumvents the fallopian tubes, it is an ideal solution for women with tubal infertility.
Norbert Gleicher, MD, FACOG, FACS
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.