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Blocked Fallopian Tubes
What Are Fallopian Tubes?
Fallopian tubes (also known as uterine tubes or salpinges) are the part of the female reproductive system that connects the ovaries to the uterus. They are long and slender tubes on either side of the uterus that function as a passageway for mature egg follicles to travel from the ovaries each cycle during ovulation. The fallopian tube captures the mature eggs from the ovary and transports it through the tube using small, hair-like, moving structures called cilia. The fallopian tube environment is extremely important for fertility because this is where conception occurs.
When an egg is released into the fallopian tube during ovulation, it will only have about 24 hours to survive in this environment and must be fertilized in this time. If live sperm is present in the fallopian tube before ovulation or if sex occurs during this 24-hour period, this can result in pregnancy. If fertilized, the embryo will spend the next 5-6 days developing within the fallopian tube until it reaches the uterus, where it can implant and grow.
What Are Blocked Fallopian Tubes?
Tubal factor infertility is any blockage or scarring that prevents the sperm from meeting the egg within the fallopian tube for fertilisation. Fallopian tubes are the passage way and help transport fertilised eggs (embryos) from the ovaries to the uterus.
Blocked fallopian tubes is a common cause of infertility and is diagnosed in 25-35% of infertile women.
The vast majority of fallopian tube blockages will not cause any physical symptoms, and most women with this condition will not be diagnosed until trying to become pregnant.
While it is still possible to become pregnant with a blocked fallopian tube, your chances of pregnancy will be highly dependent on the severity and location of your blockage, your age and ovarian reserve.
Risk factors for developing tubal factor infertility include anything that causes scarring, inflammation, or an abnormal peritoneal environment. The most common of these causes are chlamydia, gonorrhea, or other infections, or endometriosis. These factors can cause scarring between the end of the fallopian tube and the ovary, creating a blockage.
Diagnosing Blocked Fallopian Tubes
If you have been having trouble getting pregnant and are seeing a specialist, checking the fallopian tubes and uterine anomalies will be an important part of the full fertility diagnostic testing. This can be checked in three different ways.
The test to determine whether your fallopian tubes are open is called a hysterosalpingogram, or HSG. This is the least invasive but least sensitive test for diagnosing blocked fallopian tubes. It is considered one of the basic fertility tests for couples struggling to conceive. In this outpatient radiographic procedure, also known as the X-ray dye test, contrast dye is injected through the vagina and cervix into the uterine cavity and fallopian tubes. This dye can cause some cramping or pain. X-ray images are then taken over the abdomen and pelvis and the contrast imaging can inform the doctor of a blockage or scar tissue, as well as the shape and contours of the uterus.
This is the most sensitive and accurate imaging test to evaluate the fallopian tubes that requires an ultrasound, also known as the FemVue test. The test is non-radiologic method and can assess both the tubal area and the shape of the uterine cavity. In this method, a sonographic contrast containing saline, and air is injected through the vagina and cervix into the uterine cavity and fallopian tubes. If at least one fallopian tube is blocked, then the contrast fluid will accumulate between the uterus and rectum, indicating a diagnosis of tubal factor infertility. The fluid that collects inside can decrease your chance of successful pregnancy with IVF, for example.. This procedure can cause some mild side effects of pain and nausea.
In this diagnostic laparoscopy surgical procedure, the patient is put under general anaesthesis and a surgical instrument called a laparoscope is inserted through a very small incision below your belly button. To help assess the tubal area, the medical procedure, Chromopetubation, is performed. Dilute blue dye will be injected through the vagina and cervix into the uterine cavity and fallopian tubes and the surgeon can look through the laparoscope to see if either of the tubes is blocked or if there are any other visible abnormalities that may cause infertility.
Treatment Options
A few treatment options exist for tubal factor infertility to improve your chances of becoming pregnant. You may be a good candidate for in vitro fertilization (IVF) or your doctor may recommend surgery to remove the blockage if it is not too severe.
If you are having trouble becoming pregnant or if you have been diagnosed with a tubal factor infertility, it is important to speak with your physician or fertility specialist to understand all of your options and the next step in your fertility journey.