Q: I am 24 years old, underwent surgery to unblock my blocked tubes. I have now had an X-ray to find whether the operation was successful and it was not. Please, I need your advise. What can I do so that I can conceive. I really need to have the baby this year if possible.

A:In vitro fertilisation (IVF) offers the best chance for conception in patients with significant tubal disease. Often, if only 1 tube is affected, ovarian stimulation with gonadotropins produces mature oocytes in the ovary near the patent tube. In patients with minimal or moderate tubal disease, laparoscopic lysis of adhesions and procedures to normalize tubal function, with an emphasis on prevention of adhesion recurrence, offer the patient an opportunity to conceive either naturally or with minimal types of therapy. Usually, only proximal tubal occlusion occurs. Similar to an angioplastic procedure in cardiology, these obstructions can be fixed with a balloon tuboplasty under fluoroscopic guidance. There are different types of IVF procedures performed which utilise fresh or frozen donor sperms Other options include gamete intrafallopian transfer (GIFT), in which the patient undergoes a controlled ovarian hyperstimulation, the oocytes are retrieved transvaginally under ultrasound guidance, and 3-4 oocytes are placed via laparoscopy into one of the fallopian tubes along with sperm. Zygote intrafallopian transfer (ZIFT) is another option.