The fallopian tubes are part of the female reproductive tract. These are two thin tubes that are situated on either side of the uterus which connects it to the ovaries. This tube is essential for transporting the mature eggs from the ovaries to the uterus. Every month upon ovulation, a mature egg is released from the ovary. The egg needs to travel from the ovary, through the fallopian tubes and further into the uterus. Subsequently, the sperms also need to move from the cervix, through the uterus to the fallopian tubes to reach the egg for fertilisation. Fertilisation usually takes place in the fallopian tube while the egg is moving into the uterus.
What is a blocked fallopian tube?
When there is an obstruction in either one or both fallopian tubes, blocking the easy passage of eggs from the ovaries to the uterus, the female is said to have a blocked fallopian tube. This is also known as tubal factor infertility in females. This is the cause of infertility in almost 30% of women. If one or both fallopian tubes are blocked, the sperm is unable to reach the mature egg for fertilizations and thus preventing pregnancy. Many times a tube may be either partially or completely blocked. A partially blocked fallopian tube can lead to a tubal pregnancy or an ectopic pregnancy. Ectopic pregnancies are not viable pregnancies and often lead to serious life-threatening complications in the lady including death.
Symptoms of blocked tubes
A blocked fallopian tube rarely causes any symptom in the affected lady. Often the first sign of a blocked fallopian tube is infertility. If a lady is unable to conceive after one year of unprotected intercourse, they should get evaluated by a specialist. An infertility specialist may recommend a special X-ray based test to check the fallopian tubes for blockages along with another basic fertility testing.
Hydrosalpinx is a specific kind of blockage of the fallopian tubes which may in certain cases cause lower abdominal pain and unusual vaginal discharge. However, not every lady encounters these symptoms. A hydrosalpinx is caused when there is a blockage which results in the dilatation of the fallopian tube to fill up the region with fluid. This fluid-filled blockage prevents the sperm from reaching the egg and causing fertilisation.
Blockage in the fallopian tubes due to endometriosis and pelvic inflammatory disease (PID) may cause painful menstruation and sexual intercourse
Symptoms are commonly seen in PID:
- General pelvic pain
- Foul-smelling vaginal discharge
- Pain during intercourse
- Severe lower abdominal pain
Causes of blocked fallopian tubes
The most common causes of tubal blockage is due to pelvic inflammatory disease. PID is often caused due to an STD (Sexually Transmitted Disease). In many cases, it has been observed that in the absence of an active pelvic infection, many times a previous infection could still pose a high risk of a blockage.
Other causes of blocked Tubes:
- Current of the previous history of an STD such as Chlamydia or Gonorrhoea
- History of a ruptured appendix
- History of uterine infection due to abortion or miscarriage
- History of abdominal surgery
- History of ectopic pregnancy
- Surgery including fallopian tubes such as tubal ligation
Diagnosis of Blocked Fallopian Tubes
Blocked Fallopian tubes are usually diagnosed with a special X-ray test called Hysterosalpingogram or an HSG. The HSG is a basic fertility test that is recommended to couples facing fertility problems. The test involves placing an X-ray dye into the cervix using a small tube. Once the dye is taken up, an X-ray is used to examine the pelvic region. In case of a normal result, the dye travels through the cervix, uterine cavity, fallopian tubes and spills out around the ovaries into the pelvic cavity. If the dye is unable to pass through to the ovaries, there could be a possible blockage in the fallopian tube.
Other tests such as an exploratory laparoscopy may be recommended to check for blockages in the reproductive tract. A hysteroscopy involves the use of a hysteroscope which is a device with a camera inserted into the cervix to image the uterus. Further blood tests to check for Chlamydia and other STD’s may be suggested to determine the cause of the blockage.
Blocked fallopian tubes treatment
Often if a lady has a single blocked fallopian tube, she may be able to achieve a pregnancy with minimum treatment. Specialists may prescribe fertility drugs to enhance ovulation on the side of the open fallopian tube. In case a lady has blockages in both fallopian tubes, the specialist may recommend different options to treat the same.
- Laparoscopy Surgery
A laparoscopy surgery may be recommended for blocked fallopian tubes or to remove scar tissue. The results depend upon the location and severity of the blockage. It also depends on other factors such as the age of the female partner. Blockages due to a few adhesions between the tube and the ovaries have a good prognosis and usually can be treated to achieve a pregnancy.
- Tubal Ligation Reversal
Tubal ligation is one of the methods of permanent birth control. In such cases, the fallopian tubes are both cut and clamped or a special coil is inserted which prevents the meeting of the sperm and the egg for fertilization. In certain cases, the ligation is surgically reversible. Surgical reversibility of ligation is usually more successful than repairing a blockage due to an infection.
- In- vitro fertilization
In cases where surgery is unable to treat the blockage, IVF technology can be used to help couples achieve a pregnancy. In an IVF pregnancy, the sperm and egg are made to fertilise under laboratory conditions which in turn helps skip the process of the sperm travelling and fertilising the egg in the fallopian tube. The embryo formed as a result of the IVF procedure is transferred directly to the uterus and allows a higher rate of success of implantation and pregnancy. If a lady has a blockage due to a hydrosalpinx, then usually surgery is recommended to remove the same and then an IVF can be conducted.