What are blocked fallopian tubes?

Originally posted 2023-05-02 08:44:50.

Blockage of the fallopian tubes can cause infertility, but there are ways to treat it.

The fallopian tubes are two thin tubes, one on each side of the uterus, that help lead the mature egg from the ovaries to the uterus. A blocked fallopian tube, which is also known as tubal factor infertility, is when an obstruction, such as scarring, an adhesion, or infection, prevents the egg from travelling down the tube. This can happen on one or both sides, and up to 30% of infertile people with ovaries have it because of it. A fallopian tube blockage can impact fertility.

It’s unusual for people with blocked fallopian tubes to experience any symptoms. Many people with this condition think that if they get their periods on time, they are fertile. Not always, though.

Every month, when ovulation happens, one of the ovaries lets out an egg. The egg travels from the ovary, through the tubes, and into the uterus. The sperm also need to swim from the cervix, through the uterus, and through the fallopian tubes to get to the egg. Fertilization usually takes place while the egg is travelling through the tube.

If one or both of the fallopian tubes are blocked, the egg can’t get to the uterus, and the sperm can’t get to the egg. This makes it impossible for the egg to be fertilized and for a baby to be born. It’s also possible for the tube not to be blocked totally, but only partially. This can make the chance of a tubal pregnancy, also called an ectopic pregnancy, higher.

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Symptoms

Blockages in the fallopian tubes rarely cause symptoms. This is in contrast to anovulation, in which irregular menstrual cycles may be a sign of a problem. The first “symptom” of blocked fallopian tubes is often infertility. If you try to get pregnant for a year and don’t get pregnant, or if you’re 35 or older and try for six months and don’t get pregnant, your doctor will order an X-ray of your fallopian tubes and do other basic fertility tests.

A specific kind of blocked fallopian tube called hydrosalpinx may cause lower abdominal pain and unusual vaginal discharge, but not every woman will have these symptoms. Hydrosalpinx happens when a blockage causes the tube to widen and fill with fluid. The fluid gets between the egg and the sperm, stopping them from joining together and making a baby.

But some of the things that can cause the fallopian tubes to get blocked can have their own signs. For example, endometriosis and pelvic inflammatory disease (PID) may cause painful menstruation and painful sexual intercourse.

Symptoms that could indicate a pelvic infection include:

• general pelvic pain
• pain when having a sexual encounter
• foul-smelling vaginal discharge fever over 101 (in acute cases)
• nausea and vomiting (in acute cases)
• a lot of pain in the lower abdomen or pelvis (in acute cases)

Acute pelvic infections can be very dangerous and even kill you. If you have a high fever or are in a lot of pain, call your doctor right away or go to the emergency room closest to you.

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Causes

Most of the time, PID is the cause of blocked fallopian tubes. 7 A sexually transmitted disease can cause pelvic inflammatory disease, but not all pelvic infections are caused by STDs. Also, a history of PID or a pelvic infection increases the risk of blocked tubes, even if PID is no longer present.

Other things that could block the fallopian tubes are:

• Current or history of an STD infection, specifically chlamydia or gonorrhoea
• History of uterine infection caused by an abortion or miscarriage
• History of a ruptured appendix
• History of abdominal surgery
• Previous ectopic pregnancy
• Prior surgery involving the fallopian tubes, including tubal ligation
• Endometriosis

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Diagnosis

A hysterosalpingogram, or HSG, is a special kind of x-ray that is often used to find blocked tubes. An HSG is one of the most common fertility tests given to couples who are having trouble getting pregnant. A small tube is used to put a dye through the cervix as part of the test. After the dye is put in place, x-rays are taken of the pelvic area.

If everything is normal, the dye will go through the uterus and fallopian tubes, spill out around the ovaries, and go into the pelvic cavity. If the dye doesn’t go through the tubes, your fallopian tube may be blocked.

It’s important to know that 15% of women have a “false positive,” which means that the dye doesn’t get past the uterus and into the tube. It looks like the blockage is right where the fallopian tube meets the uterus. If this happens, the doctor may repeat the test another time or order a different test to confirm.

Other tests that may be ordered are an ultrasound, exploratory laparoscopic surgery, or a hysteroscopy (in which a thin camera is placed through the cervix to look at the uterus). Blood work could also be done to look for chlamydia antibodies, which would indicate a past or present infection.

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Treatment for Blocked Fallopian Tubes

If you have one open tube and are otherwise healthy, you might be able to get pregnant on your own. Your doctor may give you fertility drugs to make it more likely that you will ovulate on the side with the open tube. But if both tubes are blocked, this is not a choice.

It’s important to remember that this medicine is meant to help you get pregnant, but it won’t open up a blocked fallopian tube. In the same way, exercise can’t clear a clogged tube. Surgery is the only thing that might help clear a clogged tube, but it doesn’t always work. Here is what you need to know about IVF and tubal ligation, as well as surgery for blocked tubes.

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Laparoscopic Surgery

Laparoscopic surgery can sometimes open up tubes that are blocked or get rid of scar tissue. This treatment doesn’t always work, though. The chances of success depend on how old you are (younger is better), how bad the blockage is, where it is, and what caused it. If there are only a few adhesions between the tubes and ovaries, it is likely that you will get pregnant after surgery.

If you have a blocked tube but are otherwise healthy, you have a 20% to 40% chance of getting pregnant after surgery.

Your risk of ectopic pregnancy is higher after surgery to treat tubal blockage. If you do get pregnant, your doctor should keep a close eye on you and be there to help you decide what’s best for you.

However, surgical repair isn’t always the best option. When there are a lot of scars, moderate-to-severe endometriosis, or moderate-to-severe male factor infertility, IVF may be a better option. Your doctor can help you review whether surgical repair or going straight to IVF treatment would be best for your situation.

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In vitro fertilization

Before in vitro fertilization (IVF), women with blocked tubes had no way to get pregnant if repair surgery didn’t work or wasn’t a choice. The use of IVF makes conception possible.

As part of IVF treatment, the ovaries are stimulated by fertility drugs. Then, your doctor takes the eggs directly from the ovaries by putting a needle through the vaginal wall and guiding it with an ultrasound. In the lab, the eggs are put together with sperm from the male partner or a sperm donor. We hope that some of the eggs will grow into healthy embryos. They choose one or two healthy embryos and put them in the uterus.

IVF doesn’t use the fallopian tubes at all, so blockages don’t make a difference. That said, research has found that an inflamed tube can significantly decrease the odds of IVF success. If you have a hydrosalpinx, which is a tube filled with fluid, your doctor may suggest that you have surgery to get rid of the tube. Then, after recovering from surgery, IVF can be tried.

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Tubal Ligation Reversal

Getting your tubes tied is a common name for tubal ligation surgery, which is a permanent way to stop having children. There are different kinds of tubal ligation. A surgeon could cut the tubes, wrap them with bands, clamp them, or put special coils inside them. The goal is to block the fallopian tubes on purpose so that the sperm can’t get to the egg.

A significant number of women later regret having a tubal ligation—anywhere from 20% to 30%.

The good news is that even though this kind of birth control is considered permanent, it can be reversed for many women. It is more likely that surgery to fix a tubal ligation will work than surgery to fix a blockage caused by a disease. Most of the time, microsurgery is cheaper than IVF, sometimes by as much as half per delivery.

Success rates are generally excellent for micro-surgical tubal reversal. For women younger than 40 years of age, pregnancy rates after two years are 90%. For women over age 40, success rates vary between 40% and 70%.

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Prevention

Most blocked tubes are caused by infections in the pelvic area. Most—but not all—of these infections are caused by a sexually transmitted infection. 1 A key step in preventing tubal infertility is to get tested for sexually transmitted infections (STIs) regularly and to get any worrying symptoms checked out right away. If the STI or pelvic infection is caught and treated early enough, scar tissue may not form.

But most infections aren’t serious and don’t show any signs or symptoms right away. But “quiet” doesn’t mean harmless. The longer the infection lasts, the more likely it is that scar tissue will form and cause the tubes to become inflamed or blocked.

Once an infection has been detected, quick antibiotic treatment is important. Even if the infection is cleared up, the tubes might still be clogged. Only bacteria can be killed by antibiotics. Antibiotic treatment won’t help any damage or scar tissue that has already formed. Still, treating the disease can help stop it from doing more damage and may make it more likely that fertility treatment or surgery to fix the damage will work in the future.

To keep STIs from damaging your fallopian tubes, you should use condoms and get tested for them regularly, especially if you have risky sexual habits.

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