Blocked fallopian tubes
Find out how fallopian tubes get blocked, common symptoms, how they are diagnosed, and how they can be treated.
What are fallopian tubes?
A pair of thin tubes, one on each side of the uterus, that carry the egg from the ovaries to the uterus.
How do fallopian tubes get blocked?
The most common cause of blocked fallopian tubes is pelvic inflammatory disease (PID). Other potential causes include:
- Current or history of an STD infection specifically chlamydia or gonorrhea
- History of uterine infection caused by an abortion or miscarriage
- Endometriosis or fibroids can be associated with blockages
Types of blocked fallopian tubes
The types of blockages are determined depending where in the tube the blockage is occurring.
Distal tubal occlusion - the fallopian tube is blocked at the end closest to the ovary. This condition is commonly known as hydrosalpinx, usually caused by STIs.
Midsegment blockage - the middle segment of fallopian tube is blocked. It is a common target of sterilisation interventions, i.e. tubal ligation.
Proximal tubal occlusion - the end of fallopian tube ( near uterus ) is blocked. This may be caused by infection due to abortion, miscarriages, cesarean section, or pelvic inflammatory disease.
Blocked fallopian tubes symptoms
Not unlike other reproductive issues, women may experience certain symptoms or nothing at all.
Depending on the individual, some possible symptoms may be; strong to mild abdominal pain, fever, painful periods, strange looking or smelling vaginal discharge, or feeling pain while having sex or passing urine. however, because many women still ovulate, blocked Fallopian tubes can go unnoticed until a woman is trying to get pregnant.
How to diagnose blocked fallopian tubes
Blocked tubes are usually diagnosed with a specialized x-ray called a hysterosalpingogram (HSG). This test involves placing a dye through the cervix using a tiny tube, taking x-rays of the pelvic area and all is normal if the dye runs through the uterus. If the dye doesn’t get through the tubes, there is a blockage.
It's important to know that 15 percent of women have a "false positive," so sometimes the Doctor will need to run this test twice.
Other tests may include ultrasound, exploratory laparoscopic surgery, or hysteroscopy (where they take a thin camera and place it through your cervix to look at your uterus).
How do you treat blocked fallopian tubes
The treatment for blocked Fallopian tubes depends on where the blockage is and how severe it is. Women will be treated before embarking on her path to pregnancy to increase the chance of success.
All STIs will need to be treated with antibiotics.
Laparoscopy surgery can be performed to remove any scar tissue on the outside of the Fallopian tube, to reduce the obstruction.
If the blockage is more severe, (usually caused by a hydrosalpinx - STIs), the surgery may remove the affected part of the tube, drain any fluid and flush the tubes, to prevent the fluid from making its way back into the uterus.
Following on from this, IVF is the most effective treatment to increase the chances of pregnancy as surgery doesn’t necessarily prevent tubes from blocking again or the egg travelling freely to the uterus.
Can you still get pregnant with blocked fallopian tubes?
Can I still get pregnant with blocked fallopian tubes?
Fertile Minds Video
Welcome to Fertile Minds. I'm Dr. Manny Mangat. I'm a fertility specialist with IVF Australia.
So to answer that question, the answer is, yes. So let's start at the beginning. What are fallopian tubes? I brought my little model. So this is our uterus. And on each side of the uterus, we've got a tube. It is the tube that transports the egg that is released from the ovary into the uterus, where the embryo implants and forms a baby. So each of us are born or should be born with two fallopian tubes, one on each side.
Now, in order to conceive naturally, we need functioning eggs, which live in the ovaries. We need functioning sperm. We need to ovulate at the right time in the menstrual cycle. And once the egg is released, it is caught by the fallopian tube and sperm meets the egg in the tube and then the embryo created is transported into the uterus to implant into a receptive lining or endometrium.
There are many reasons that can cause blocked tubes. Sometimes we are born without a fallopian tube or born with a blocked tube. Other times it could be as a result of infection or inflammation. So pelvic infection like chlamydia, inflammation caused by endosalpingiosis or endometriosis. And it can also be blocked from obstructive causes, like big fibroids that are pressing on the tube.
I suppose, if we do have blocked tubes, how do we know they're blocked? Now, most patients don't have any symptoms or pain. A small percentage of patients when they do have an infection may have fevers or acute pain. Other patients may have one sided pain or abnormal discharge during their menstrual cycle if they have a swollen tube that is collecting fluid. However, as I said, a lot of people don't know that they could have a blocked tube. Therefore, once you're ready to start trying to have a baby, you may have read a few things about tracking your ovulation and timing intercourse. And if you've tried for up to six cycles and nothing is happening, you may then choose to see your GP. And after a few basic investigations, your GP may recommend you see a fertility specialist.
Once you see a specialist, we often organise what's called a hysterosalpingogram or a high cosy. This is not an operation. It is an ultrasound where we look at the uterus and tubes. However, a plain ultrasound is not going to tell us if the tubes are functioning. So we then put some saline or salty water into the uterus and watch it spill out the fallopian tubes. And that then tells us if the tubes are patent or working. Sometimes the pain from that fluid or pressure, may cause the tube to spasm. That's why we recommend you take two pain relief tablets, 30 minutes before the procedure and your doctor will explain the results if that is the case.
Now, if you have been diagnosed with blocked tubes, if only one tube is blocked, remember there's always the other one. And it doesn't automatically half your chances of pregnancy. Because you have two ovaries that should sit freely and tubes, if not damaged, sit freely behind the uterus in this area. Therefore, even if this tube is missing, but that ovary ovulates, this tube can still sometimes transport that egg to the right place.
However, if your tube is damaged, then there are increased risks of ectopic pregnancy, where the pregnancy may form in the damaged tube. So options for treatment are different if one tube is blocked or if both tubes are blocked, and your doctor will go through all options with you. So often when we're missing one tube, we would still suggest you try for a little bit longer, depending on your age, your egg reserve and your partner's sperm quality. If both tubes are blocked, however, then we would talk to you about assisted reproduction.
In the past, you may have heard about surgery to fix the tube. We can still try to repair a block tube or recanalise it, but because the very fine inner workings of the tube is often damaged once it's swollen or blocked, the risk of then developing an ectopic pregnancy outside the uterus or a pregnancy stuck in that tube, is much, much higher even once we have repaired that tube. Therefore these days with the increase of success rates with IVF treatment, where we bypass the tubes altogether, we take the eggs out of the ovaries.
We make embryos in the lab and we then transfer the embryo back into the uterus, therefore not relying on your fallopian tubes. This seems to be the safer option of treatment. If you do have a blocked tube that is collecting fluid in it, that can sometimes backflow into the uterus and also reduce implantation with assisted reproduction or IVF. So if that is applicable to you, your fertility specialist may talk about options of fixing that prior to an IVF cycle. So there are many treatment options available depending on what is affected with the tubes and what your individual circumstance is.
And we will be more than happy to guide you through all your available options. And you will certainly have a good opportunity of a successful pregnancy. If you have any questions, please feel free to leave a comment. And to keep up-to-date with all things fertility, don't forget to press the subscribe button. Thank you.