Blocked fallopian tubes and fertility

Blocked fallopian tubes are one of the main causes of female infertility, accounting for 30-40% of all infertility cases. In fact IVF was first invented to treat blocked fallopian tubes, with the first IVF baby, Louise Brown born in 1978.  

The fallopian tubes are a part of the female reproductive tract where the egg and the sperm meet during natural conception. When fallopian tubes become blocked, it can prevent the egg or embryo from reaching the uterus where it would implant and lead to a successful pregnancy. 

The impact of blocked fallopian tubes on fertility can vary depending on the severity and location of the blockage. However, not all cases of blocked fallopian tubes result in infertility. Some women may still be able to conceive with the help of assisted reproductive technologies such as in vitro fertilisation (IVF).

What causes blocked fallopian tubes?

There are several causes of blocked fallopian tubes. One of the most common causes is pelvic inflammatory disease (PID), which is often the result of untreated sexually transmitted infections (STIs) such as chlamydia or gonorrhoea. PID causes inflammation and scarring of the fallopian tubes, leading to blockages.

Endometriosis is another condition that causes blockages in the fallopian tubes. In endometriosis the tissue that normally lines the uterus (endometrium) grows outside the uterus. If this tissue implants and grows within the fallopian tubes, it can lead to blockages and affect the normal functioning of the tubes.

Certain surgeries or procedures performed in the pelvic area, such as surgeries to remove ovarian cysts or treat ectopic pregnancies, can result in scar tissue. This scar tissue can cause blockages in the fallopian tubes.

Rarely, some people may be born with structural abnormalities in their fallopian tubes, such as a blockage or abnormal shape, which can impact normal functioning and contribute to fertility issues.

What are the symptoms of blocked fallopian tubes?

Not everyone with blocked fallopian tubes experiences symptoms. However there are some signs and symptoms associated with them, including: 

• Infertility - difficulty in conceiving or experiencing recurrent miscarriages can indicate blocked fallopian tubes. If the eggs cannot reach the uterus or the sperm cannot reach the eggs due to blockages, natural fertilisation and pregnancy may be difficult.

• Irregular periods -  This can be changes in the length, flow, or timing of the menstrual period.

• Pelvic pain - some women with blocked fallopian tubes may experience intermittent or chronic pelvic pain. The pain may range from mild discomfort to sharp or cramp-like sensations. The severity and duration of pain can vary.

• Uterine infections - history of uterine infections caused by an abortion or miscarriage.

• Unusual vaginal discharge - in some cases, blocked fallopian tubes can cause abnormal vaginal discharge. The discharge may have an unusual odour, colour, or consistency.

These symptoms are not exclusive to blocked fallopian tubes and can be associated with other gynaecological or reproductive conditions.

Therefore, it is a good idea to see your doctor for further investigation if you are experiencing any fertility concerns or related symptoms.

HSG and HyCoSy imaging 

Hysterosalpingography (HSG) and Hystero-salpingo Contrast Sonography (HyCoSy) are two common imaging procedures used to check whether the fallopian tubes are blocked. During the procedures, a dye is injected into the uterus and fallopian tubes through the cervix, and X-ray images are taken. The dye should flow freely through the fallopian tubes if they are not blocked. 

Laparoscopy 

Laparoscopy is a minimally invasive surgical procedure that allows a doctor to see your pelvic organs, including the fallopian tubes. It involves making small incisions in the abdomen and inserting a thin, flexible instrument with a camera (laparoscope) to examine the reproductive organs. If blockages or other abnormalities are detected, additional surgical interventions may be performed during the laparoscopy.

Transvaginal ultrasound 

Ultrasound is an imaging technique that uses sound waves to create images of the pelvic organs. While it cannot directly visualise the fallopian tubes, it can provide information about the size, shape, and condition of the uterus and ovaries. It can also help identify other potential causes of infertility. Fallopian tubes that are blocked with fluid, due to inflammation, can sometimes be detected via an ultrasound scan.  

Blood tests

Finally, blood tests may be conducted to check for certain infections, hormonal imbalances, or other factors that could contribute to fallopian tube blockages or fertility issues.

Blocked fallopian tubes treatments

The good news is there are fertility treatment options for blocked fallopian tubes and what works best for you depends on the severity and location of the blockage, as well as individual factors. Sometimes surgery is recommended to remove or repair the blockage, while in other instances, assisted reproductive technologies like IVF may be considered to bypass the fallopian tubes altogether.

In vitro fertilisation (IVF)

IVF is an assisted reproductive technology that skips the fallopian tubes entirely and for this reason is the main treatment for patients with blocked fallopian tubes. It involves collecting eggs from the ovaries and fertilising them with sperm in a laboratory. Successfully fertilised embryos are then either transferred back into the uterus to grow, and surplus embryos can be frozen for future cycles. The success rates of IVF will depend on the quality of your eggs, age and other factors. 

You can read more about IVF here. 

Surgery

Sometimes your specialist will recommend surgery to either remove or repair the blockage in the fallopian tubes. 

If the blockage is due to adhesions, scar tissue, or other localised factors, surgical procedures such as tubal ligation reversal or salpingostomy may be considered. These surgeries aim to remove the blockage or create a new opening in the fallopian tube to restore its function.

In cases where the blockage is in the narrowest part of the fallopian tube, a minimally invasive procedure called tubal cannulation may be performed. It involves inserting a thin catheter or wire into the fallopian tube to clear the obstruction and restore the passage for eggs and sperm.

Getting the support you need 

Infertility caused by blocked fallopian tubes can feel difficult and emotionally challenging. However, it's important to remember that having blocked fallopian tubes does not necessarily mean you cannot have children. IVF has been successfully used to help individuals and couples with blocked fallopian tubes have healthy pregnancies and babies.