Overview: Blocked fallopian tubes
There are many conditions that can cause fertility problems in men and women. The fallopian tubes are a part of the female reproductive system and are responsible for carrying eggs from the ovary to the uterus. Fertilisation usually takes place in the fallopian tube. The fertilised egg then passes though the tube to implant itself in the uterus and starts to develop.
A blockage in the fallopian tube will mean the passage for the sperm to reach the egg, and the path to the uterus for a fertilised egg, is blocked. There can be many reason for blocked fallopian tubes, including scar tissue, infection, and pelvic adhesions.
What are the symptoms of blocked fallopian tubes?
Usually there are no noticeable symptoms associated with blocked fallopian tubes. Most women only realise there is a problem with their tubes once they start trying for a baby and are examined by a fertility specialist.
On rare occasions, blocked fallopian tubes can cause some mild, but regular, discomfort in the abdominal area. the discomfort may be concentrated on one side of the abdomen. Experiencing a symptom like this may be an indication of another complication associate with blocked fallopian tubes called a hydrosalpinx. This means fluid has filled and enlarged a blocked fallopian tube.
Some conditions that can lead to blockages, like endometriosis, may have their own symptoms which can cause serious pain and heavy bleeding, and can increase the chance of getting blocked tubes.
How blocked fallopian tubes can affect fertility?
For pregnancy to occur naturally there needs to be a clear path for sperm and egg to meet in the fallopian tube, and for the fertilised egg to pass through and implant itself to the uterus. A blocked fallopian tube will prevent this from happening.
If there is blockage in both the tubes fertility will not be possible. If they are partially blocked, fertility may be possible, but the risk of ectopic pregnancy will be much higher. Ectopic pregnancy is when the fertilised egg doesn’t attach to the uterus, instead it may attach to the fallopian tube, abdominal cavity, or cervix.
Any level of blockage will make it harder for fertilised eggs to pass through successfully. In this case your doctor may recommend fertility treatment to increase the chance of successful conception.
If one fallopian tube is blocked, natural conception should be possible without any problems. Fertility drugs may be used to increase ovulation to produce more eggs on the unblocked side.
What can cause blocked fallopian tubes?
There are many factors that can cause blockages in fallopian tubes, these include:
- Pelvic inflammatory disease (PID)
- Some sexually transmitted infections
- Past ectopic pregnancy
- Uterine fibroids
- Past abdominal surgery
How to diagnose blocked fallopian tubes?
A specific type of x-ray called Hysterosalpingography (HSG) is used to inspect the fallopian tubes and diagnose whether there is a blockage. The doctor carrying out the examination will introduce a dye which helps them see inside the fallopian tubes on the x-ray.
If the x-ray is inconclusive, they can try laparoscopy, a minimally invasive surgical procedure used to examine organ in the abdomen. It is a low risk procedure carried out through a small incision. If a blockage is discovered it may be removed, if possible.
Procedures to unblock fallopian tubes
Salpingectomy – The removal of part of the fallopian tube. Often carried out before IVF
Salpingostomy – The procedure is carried out when the end of the fallopian tube, nearer the ovary, is blocked. The doctor creates a new opening in the fallopian tube, but the results are usually temporary.
Selective tubal cannulation – Doctors insert a catheter through the cervix, uterus and into the fallopian tube.
Tubal ligation removal – Doctor removes the part of the fallopian tube that was tied or cauterized in the original surgery and reattaches the two ends to make a complete tube.
Complications of blocked fallopian tubes
Ectopic pregnancy, which occurs outside the uterus, is one of the most common complication with blocked fallopian tubes. If the fallopian tube is not completely blocked the egg and sperm may reach each other and fertilisation may take place, but there is a risk that the fertilised egg will get stuck in the tube instead of going down to the uterus. If this happens then it is a medical emergency that needs to be dealt with immediately.
Medical procedures, or surgeries, carried out to remove blockages can also increase the risk of ectopic pregnancy. You may find, because of the risk, a lot of doctors are reluctant to go down the surgical route, and are more likely to recommend IVF as a fertility treatment.
There may be other medical procedures available to treat blocked fallopian tubes. To see what options are available to you, you’ll need to get assessed by your doctor, who will determine what is causing the problem, and recommend an appropriate solution.
Fertility treatments to increase the change of pregnancy
Most fertility drugs given to women are used to help with ovulation. Clomifene and gonadotrophins are among the most commonly prescribed fertility drugs by doctors. They work by regulating your reproductive hormones and trigger the release of eggs in each ovulation cycle.
ICSI Is a fertility treatment for men and is quite often combined with IVF treatment. ICSI requires only one healthy sperm cell, which is injected directly into the egg. The embryo, or fertilised egg, is then placed back into the womb to grow and develop.
Intrauterine insemination (IUI) is a fertility treatment carried out to help with certain types of fertility problems. It works by placing sperm inside the uterus to increases the odds of sperm reaching the fallopian tubes and pregnancy occurring.
This procedure will only work if the fallopian tubes allow for sperm to pass through, requires at least one health tube.
One of the best-known fertility treatments, the procedure works by extracting an egg from the women’s ovaries and fertilising it outside of the body in a laboratory. The fertilised egg is then returned to the womb to develop.
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