The fallopian tubes are two thin tubes, one on each side of the uterus, which leads the mature egg from the ovaries to the uterus. If an obstruction prevents the egg from traveling down the tube, it means that the woman has a blocked fallopian tube, also known as tubal factor infertility. This can occur on one or both sides and is the cause of infertility in 40 percent of cases.
Blocked Fallopian Tubes & Infertility
Each month, when ovulation happens, an egg is released from one of the ovaries. The egg then travels from the ovary, through the tubes, and into the uterus. The sperm also make its way from the cervix, through the uterus, and through the fallopian tubes to finally get to the egg. Fertilization usually occurs while the egg is traveling through the tube.
In case of blockage in one or both fallopian tubes, the egg cannot reach the uterus, and the sperm cannot reach the egg, hence, preventing fertilization and pregnancy. There is a possibility that the tube is not blocked totally, but only partially. This further increases the risk of a tubal pregnancy, or ectopic pregnancy!
Symptoms of Blocked Fallopian Tubes
Unlike anovulation, where irregular menstrual cycles may suggest that there is a problem, blocked fallopian tubes rarely cause symptoms. 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 is when a blockage causes the tube to dilate (increase in diameter) and fill with fluid. The fluid blocks the egg and sperm, therefore, preventing fertilization and pregnancy.
However, some of the causes of blocked fallopian tubes can lead to other problems. For example, endometriosis and pelvic inflammatory disease may result in painful menstruation and painful sexual intercourse, but these symptoms do not always point to blocked tubes.
Causes of Blocked Fallopian Tubes
The most common cause of blocked fallopian tubes is pelvic inflammatory disease(PID). PID is caused due to sexually transmitted disease. Having said that, not all pelvic infections are related to STDs. Also, in case, PID is no longer present, a history of PID or pelvic infection does increases the risk of blocked tubes.
Other possible causes of blocked fallopian tubes include:
- Current or history of an STD infection, specifically chlamydia or gonorrhea
- History of a ruptured appendix
- History of abdominal surgery
- History of uterine infection caused by an abortion or miscarriage
- Previous ectopic pregnancy
- Prior surgery involving the fallopian tubes
How are Blocked Tubes Diagnosed?
Blocked tubes are generally diagnosed with a specialized x-ray called a hysterosalpingogram, or HSG. This test is done by placing a dye through the cervix using a tiny tube. Once the dye has been given, the doctor will take x-rays of your pelvic area.
If everything is fine, the dye will go through the uterus, through the tubes, and spill out around the ovaries and into the pelvic cavity. If the dye does not get through the tubes, then you may have a blocked fallopian tube. You should know that 15 percent of women have a “false positive,” where the dye doesn’t get past the uterus and into the tube. If the blockage appears to be right where the fallopian tube and uterus meet, then the doctor may repeat the test another time, or order a different test to confirm.
Other tests that your doctor might ask you to do include ultrasound, hysteroscopy or exploratory laparoscopic surgery (where they take a thin camera and place it through your cervix to look at your uterus). Bloodwork to check for the presence of Chlamydia antibodies (which would imply previous or current infection) may also be ordered.
Possibility of pregnancy with Blocked Fallopian Tubes- Potential Treatments:
If you have one open tube and are otherwise healthy, you might be able to get pregnant without too much help. Your doctor may give you fertility drugs to increase the chances of ovulating on the side with the open tube. However, the same cannot be done if both tubes are blocked.
Laparascopic Surgery for Blocked Fallopian Tubes
In some cases, laparoscopic surgery can open blocked tubes or remove scar tissue that is causing problems. Unfortunately, this treatment doesn’t always work. The chance of success depends on age (the younger, the better), the severity of blockage (how bad and where the blockage is), and the cause of blockage.
If just a few adhesions are between the tubes and ovaries, then your chances of getting pregnant after surgery are good. If you have a blocked tube that is otherwise healthy, your chance of getting pregnant is between 20 percent to 40 after surgery.
If there are thick, multiple adhesions and scarring between your tubes and ovaries, or if you have been diagnosed with hydrosalpinx, surgery may not be a good option for you. Also, if there are any male infertility issues, you might want to skip surgery. In these cases, IVF treatment is your best bet.
It is also important to note is that your risk of ectopic pregnancy is higher after surgery to treat tubal blockage. Your doctor will have to closely monitor you if you do get pregnant and help you to decide what’s best for you.
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