Key concepts of blocked fallopian tubes
- A blockage or damage of the fallopian tubes can disrupt peri-conception events and be associated with infertility.
- The fallopian tube allows an egg to move from the ovary into one of the two fallopian tubes; the fallopian tube is where sperm meets an egg for fertilization; and the fertilized egg (embryo) moves to the uterus through the tube for pregnancy.
- Tubal blockage is the cause of 25% of female infertility cases.
- Pelvic inflammatory disease, past surgeries, endometriosis, and other conditions can cause obstruction of the fallopian tubes and infertility.
- Surgical treatment and other procedures may unblock the tubes, although internal scarring may remain and result in an ectopic pregnancy.
- In general, in vitro fertilization (IVF) is the best and safest option for achieving a pregnancy with blocked tubes.
How blocked fallopian tubes cause infertility
Fallopian tubes connect the ovaries to the uterus and play a key role in conception. When the tubes are damaged or blocked, either completely or partially, this can disrupt the normal fertilization and implantation events from progressing.
- During ovulation, the ovary releases an egg into a fallopian tube.
- Sperm released into the vagina during intercourse travels through the cervix and uterus into the fallopian tube where it meets and fertilizes the egg.
- The resulting embryo then travels through the tube back to the uterus for pregnancy.
Tubal infertility can result due to initial fertilization not happening or the fertilized egg not reaching the uterus for implantation. Damaged or blocked fallopian tubes is the cause of more than 25% of female infertility cases, according to the National Library of Medicine.
If only one fallopian tube is blocked, a woman can still get pregnant naturally. But it can depend on her other tube being healthy, regular ovulation and her otherwise good reproductive health.
Blocked fallopian tubes FAQ
How does a blocked fallopian tube cause infertility? It can prevent an egg from entering the fallopian tube, sperm from reaching the egg there for fertilization or an embryo to travel to the uterus from pregnancy
What causes blocked fallopian tubes? Pelvic inflammatory disease, previous surgeries, and endometriosis and other conditions.
How is the condition treated? Surgeries of salpingectomy and salpingostomy or tubal cannulation procedure.
If the blocked tubes can’t be corrected, can a woman still get pregnant? Yes, with IVF.
What causes blocked fallopian tubes (tubal occlusion)?
Damaged or blocked fallopian tubes, also known as tubal occlusion, tubal disease and tubal infertility, may be caused in several ways. The most common way the tubes can be blocked is when some form of infection scars the tube’s walls.
Other causes can be from structural abnormalities of the tubes at birth, a surgery, medical conditions and when the tubes were tied (tubal ligation) intentionally for sterilization. Blocked fallopian tubes can be caused by the following conditions.
Pelvic inflammatory disease (PID)
Pelvic inflammatory disease is usually a bacterial infection that occurs when sexually transmitted diseases are not treated. Gonorrhea and chlamydia are common causes of PID. This in turn causes inflammation near the fallopian tubes and blockage. Antibiotics can treat PID but may not prevent tubal damage from occurring.
Endometriosis
Endometriosis is when tissue from the uterine lining, called the endometrium, grows outside of the uterus where it causes inflammation and scar tissue. When endometriosis occurs on the fallopian tubes, or near them, it can cause blockage resulting in infertility in women.
Ectopic pregnancy
This is a life-threatening form of pregnancy in which an embryo implants outside the uterus, often on a fallopian tube. The embryo cannot grow there and can cause the fallopian tube to rupture, endangering the mother. The fallopian tube can be saved by surgery that removes the misplaced fertilized egg.
Previous reproductive surgery
Surgeries in the reproductive and abdominal areas can cause scarring that results in fallopian tube obstruction. For example, surgical removal of uterine fibroids and for endometriosis can cause blockage of the tubes. Cases of inflamed or ruptured appendicitis may also cause tubal damage due to the proximity of the appendix to the right fallopian tube.
Blockages can also result from adhesions forming after abdominal and pelvic surgeries such as ovarian cyst removal and C-section.
Primary types of blocked fallopian tubes
Hydrosalpinx
Hydrosalpinx is a specific type of fallopian tube blockage when the tube is filled with fluid, leading to swelling and obstruction. Hydrosalpinx is associated with the end of the tube near the ovary filling with fluid. When the tube is blocked by scarring, the cells release fluid resulting in hydrosalpinx.
Proximal tubal occlusion
This is a blockage of a fallopian tube near the end that meets the uterus, or the opposite end from hydrosalpinx. Causes of proximal tubal occlusion include endometriosis, fibroids, inflammation and scarring from other conditions.
Blocked fallopian tube symptoms
Quite often, the only symptom of blocked tubes is not being able to conceive. Trying to determine a cause of infertility often leads to a fertility specialist discovering the tubal disease.
Other symptoms are related to the cause of the blocked tubes. These symptoms include painful periods, pain during intercourse, vaginal discharge and heavy bleeding during or between periods. If hydrosalpinx is the cause of the blockage, a woman can experience abdominal or pelvic pain.
How to open blocked fallopian tubes
Diagnosis by hysterosalpingogram
The hysterosalpingogram test (HSG), also called a hysterosalpingography, is the way fertility specialists usually diagnose blocked tubes. This is an X-ray exam using a solution with dye that provides contrast so the tubal blockage can be evaluated. It is also possible that a doctor will conduct minimally invasive laparoscopic surgery after the hysterosalpingogram to get a better view of the extent of the blockage.
Salpingectomy or salpingostomy surgery for hydrosalpinx
These two types of surgery are used in cases of blocked tubes due to fluid buildup in hydrosalpinx. In a salpingectomy, the surgeon laparoscopically removes the entire fallopian tube. Pregnancy will then need to occur either in the unaffected tube or else with IVF.
A salpingostomy creates an opening in the fallopian tube near the ovary that is blocked. This allows eggs from the ovary to enter the fallopian tube. This can be done with laparoscopy or open surgery.
A fimbrioplasty is a type of salpingostomy that creates an opening in the blocked tube and rebuilds the fimbriae. These are finger-like projections at the ovary end of the fallopian tube that sweep the egg into the tube after the ovary releases it.
After these surgeries, new scarring can occur in the fallopian tubes. The risk of having an ectopic pregnancy also increases after these procedures. Other risks include surgical complications such as bleeding, pain, infection, and damage to nearby organs and tissue.
Tubal cannulation
Tubal cannulation is a non-surgical means of removing blockages, most often performed in cases of proximal tubal occlusion at the uterus end of the fallopian tube. Tubal cannulation involves a doctor inserting a catheter through the vagina and uterus, guided by X-ray or ultrasound to locate the blockage. By inflating a small balloon or using a wire tool, the doctor can remove the blockage.
Tubal ligation reversal
This procedure undoes a tubal ligation, which is the surgical closing of the fallopian tubes as a form of sterilization. In tubal reversal ligation, the doctor removes the blockages (rings, clips, etc.) that were previously added to the fallopian tube to prevent pregnancy. This can involve removing a section of the tube where the blocking device was placed and reattaching the two healthy ends together. This surgery may or may not be possible depending on the type of tubal ligation that was performed.
Pregnancy after fallopian tube treatment
Factors that affect a woman’s chances of natural pregnancy after fallopian tube blockage treatments include her age, severity of the tubal scarring that occurred and the length of the fallopian tube involved. Pregnancy is more likely when the blockage was near the uterus. Women over the age of 35 may be more likely to need intrauterine insemination (IUI) or IVF to conceive.
For those with fallopian tube damage that cannot be treated effectively, IVF is the best and most successful option for pregnancy. In IVF, egg retrieval, fertilization in the lab and implantation of an embryo in the uterus bypass the need for the fallopian tubes.
Final thoughts on tubal disease
Though fallopian tube issues are a major cause of infertility in women, treatments can restore their fertility for natural pregnancy. When such treatments are unable to restore fertility, IVF is the treatment that can allow patients to have a child of their own. We work closely with patients to understand this condition, accurately diagnose the fallopian problems, discuss treatment options and provide effective treatment.