What are fallopian tubes?

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 [1].

How do I know if I have blocked fallopian tubes?

Unlike other common gynecological conditions, blocked fallopian tubes rarely show any symptoms. Some women may have blocked fallopian tubes their entire life and not experience any symptoms.

A unique and rarer type of blocked fallopian tube called ‘hydrosalpinx’ may cause lower abdominal pain and unusual vaginal discharge, but not every woman will have these symptoms. This is when your fallopian tube is blocked and filled with a clear watery fluid. The inflammatory fluid can leak into the uterine cavity and preventing normal implantation of the embryo.

What causes 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.

How can the fallopian tubes affect fertility?

When ovulation occurs each month, an egg is released from one of the ovaries. It travels through the fallopian tubes and towards the uterus. The sperm need to swim from the cervix up into the uterus and into the fallopian tube where the egg has been released. Fertilisation usually takes place in the fallopian tube when the egg and the sperm meet.

If one or both of the tubes are blocked, the sperm cannot reach the egg. This means that fertilisation cannot happen and a pregnancy cannot be achieved. If only one of your tubes is blocked, then your specialist may suggest medication that encourages more frequent ovulation on the side of the unblocked tube.

Although blocked fallopian tubes can make it difficult to achieve a pregnancy, they are relatively easy to diagnose for a specialist.

How to diagnose blocked fallopian tubes?

If an individual or couple is struggling to conceive for no known reason, fertility specialists will often investigate the possibility of blocked tubes. There are several medical tests that can detect some type of blockage.

Hysterosalpingogram (HSG)

An HSG is an x-ray test that uses a contrasting dye to view an obstruction in the fallopian tubes. The dye is inserted into a thin tube that is placed through the vagina and into the uterus. Once the uterus is filled with this dye, it will then spill into the fallopian tubes. X-rays are then taken to see if there is anything blocking the tubes. It is usually carried out without a general anesthetic.

Sonohysterography

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

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.

How can blocked fallopian tubes be treated?

Once your fertility specialist has diagnosed blocked fallopian tubes there are many different ways that they can be treated and un-blocked. 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 [4] 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.

If you are concerned about your fertility and think you may have blocked fallopian tubes, consulting a specialist will help put your mind at ease, answer any questions that you may have and can help you on the right path to pregnancy.

 

 

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