Blocked Fallopian Tubes: Symptoms, Causes and Treatment for Fertility
Fallopian tubes connect a woman’s ovaries to her uterus, allowing an egg to travel through the fallopian tubes to the uterus. Most women have two ovaries (left and right) where your egg follicles are stored. Each month a follicle matures and it is releases an egg into the fallopian tubes. Fallopian tubes are two thin tubes, one linking to each ovary to help move the mature egg from the ovaries to the uterus. When there is an obstruction in one or both of the fallopian tubes the condition is known as blocked fallopian tubes or tubal factor infertility. This can occur on one or both tubes and is one of the main causes of female infertility.
Causes for Blocked Fallopian Tubes
There are a number of reasons why your fallopian tubes can be blocked:
- Pelvic inflammation
Pelvic inflammation is the most common cause of blocked tubes. The inflammation usually happens inside your fallopian tubes which is usually the case with sexually transmitted infections (STIs) such as gonorrhea or chlamydia. The inflammation can also occur outside your tubes due to an infection from another organ such as the appendix.
- Blocked from birth (congenital tubal obstruction)
A very rare condition which is present from birth.
- Accidental damage following other surgery
It is possible for your fallopian tubes to be blocked by excessive scar tissue from previous surgery
- Severe endometriosis
Fallopian tubes can become damaged or blocked in severe cases of endometriosis due to adhesions or scar tissue.
- Endometriosis. Endometrial tissue can build up in the fallopian tubes and cause a blockage, or endometrial tissue on the outside of other organs can cause adhesions that block the fallopian tubes.
- Certain sexually transmitted infections. Chlamydia and gonorrhea can cause scarring and lead to pelvic inflammatory disease.
- Past ectopic pregnancy. This can scar the fallopian tubes.
- Fibroids. These growths can block the fallopian tube, particularly where they attach to the uterus.
Past abdominal surgery.
- Past surgery, especially on the fallopian tubes themselves, can lead to pelvic adhesions that block the tubes.
Diagnosing a blocked fallopian tube
Hysterosalpingography (HSG) is a type of X-ray used to examine the inside of fallopian tubes to help diagnose blockages. During HSG, your doctor introduces a dye into your uterus and fallopian tubes. The dye helps your doctor see more of the inner fallopian tubes on the X-ray. An HSG can usually be done in your doctor’s office and should take place within the first half of your menstrual cycle. Side effects are rare, but false positive results are possible.
If the HSG doesn’t help your doctor make a definitive diagnosis, they can use laparoscopy for further evaluation. If the doctor finds a blockage during the procedure, they might remove it, if possible.
Sonohysterography is a non-invasive procedure where ultrasound imaging is used instead of the potentially more damaging x-rays. Similar to the HSG, a thin tube is placed through the vagina and into the uterus to see if there is a blockage in the tubes. The ultrasound examination can also diagnose a hydrosalpinx and other issues such as ovarian cysts, endometrial polyps and uterine fibroids. It can be carried out without a general anesthetic.
Chromotubation is performed during a laparoscopy so that your specialist can see the dye spilling from the fallopian tube. The dye for this procedure is different from a HSG as it cannot be seen on an X-ray. This test is considered the most reliable way to determine if you have blocked tubes but does require surgery and a general anesthetic.
Blocked fallopian tubes Treatment
If your fallopian tubes are blocked by small amounts of scar tissue or adhesions, your doctor can use laparoscopic surgery to remove the blockage and open the tubes. If your fallopian tubes are blocked by large amounts of scar tissue or adhesions, treatment to remove the blockages may not be possible.
If you only have one tube that is blocked, your fertility specialist may recommend continuing trying to conceive naturally as it is still possible to conceive. If both tubes are blocked then laparoscopic surgery or microsurgery  may be an option to try and open one or both of the fallopian tubes. If there are only a few adhesions between your tubes and your ovaries then your chance of conceiving naturally after the surgery is good.
In some cases, if surgery is ineffective, then IVF may be an option. IVF bypasses the need for fertilization to occur in the fallopian tubes by placing an embryo directly into the uterus.
Surgery to repair tubes damaged by ectopic pregnancy or infection may be an option. If a blockage is caused because part of the fallopian tube is damaged, a surgeon can remove the damaged part and connect the two healthy parts.
Complications of blocked fallopian tubes
The most common complication of blocked fallopian tubes and treatment is ectopic pregnancy. If a fallopian tube is partially blocked, an egg may be able to be fertilized, but may get stuck in the tube. This results in an ectopic pregnancy, which is a medical emergency.
Surgery that removes part of the fallopian tube also increases the risk of ectopic pregnancy. Because of these risks, doctors often recommend IVF instead of surgery for women with blocked fallopian tubes who are otherwise healthy.
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