Blocked Fallopian Tubes: Symptoms and Treatment

The fallopian tubes are two thin tubes, one on each side of the uterus, which help lead the mature egg from the ovaries to the uterus. When an obstruction prevents the egg from traveling down the tube, a 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 infertile women.

It's unusual for women with blocked fallopian tubes to experience any symptoms. Many women assume that if they are having regular periods, their fertility is fine. This isn't always true.

Overview

Each month, when ovulation occurs, an egg is released from one of the ovaries. The egg travels from the ovary, through the tubes, and into the uterus. The sperm also need to swim their way from the cervix, through the uterus, and through the fallopian tubes to get to the egg. Fertilization usually takes place while the egg is traveling through the tube.

If one or both fallopian tubes are blocked, the egg cannot reach the uterus, and the sperm cannot reach the egg, preventing fertilization and pregnancy.

It's also possible for the tube not to be blocked totally, but only partially. This can increase the risk of a tubal pregnancy, or ectopic pregnancy.

Symptoms

Unlike anovulation, where irregular menstrual cycles may hint to a problem, blocked fallopian tubes rarely cause symptoms. The first “symptom” of blocked fallopian tubes is often infertility. If you don’t get pregnant after one year of trying (or after six months, if you’re age 35 or older), your doctor will order a specialized X-ray to check your fallopian tubes, along with other basic fertility testing.

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, 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 cause painful menstruation and painful sexual intercourse, but these symptoms don't necessarily point to blocked tubes.

Causes

The most common cause of blocked fallopian tubes is pelvic inflammatory disease (PID). PID is the result of a sexually transmitted disease, but not all pelvic infections are related to STDs. Also, even if PID is no longer present, a history of PID or pelvic infection increases the risk of blocked tubes.

Other potential causes of blocked fallopian tubes include:

  • Current or history of an STD infection, specifically chlamydia or gonorrhea
  • History of uterine infection caused by an abortion or miscarriage
  • History of a ruptured appendix
  • History of abdominal surgery
  • Previous ectopic pregnancy
  • Prior surgery involving the fallopian tubes
  • Endometriosis

Diagnosis

Blocked tubes are usually diagnosed with a specialized x-ray called a hysterosalpingogram, or HSG. This test involves 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. An HSG is considered one of the basic fertility tests ordered for every couple struggling to conceive. Along with the HSG, you’ll likely have blood work, and your male partner will have a semen analysis.

If all is normal, the dye will go through the uterus, through the tubes, and spill out around the ovaries and into the pelvic cavity. If the dye doesn't get through the tubes, then you may have a blocked fallopian tube.

It's important to know that 15 percent of women have a "false positive," where the dye doesn't get past the uterus and into the tube. The blockage appears to be right where the fallopian tube and uterus meet. If this happens, the doctor may repeat the test another time, or order a different test to confirm.

Other tests that may be ordered include ultrasound, exploratory laparoscopic surgery, or hysteroscopy (where they take a thin camera and place it through your cervix to look at your uterus). Blood work to check for the presence of chlamydia antibodies (which would imply previous or current infection) may also be ordered.

Treatment

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. This is not an option, however, if both tubes are blocked.

Laparoscopic 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 how old you are (the younger, the better), 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, you have a 20 percent to 40 percent chance of getting pregnant after surgery.

Your risk of ectopic pregnancy is higher after surgery to treat tubal blockage. Your doctor should closely monitor you if you do get pregnant and be available to help you decide what's best for you.

Surgery isn't right for everyone. If thick, multiple adhesions and scarring are 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. Other reasons to forgo surgery include additional fertility factors besides blocked fallopian tubes (like serious problems with ovulation) or advanced maternal age. In these cases, IVF treatment is your best bet.

IVF for Blocked Fallopian Tubes

Before the invention of IVF, if repair surgery didn't work or wasn't an option, women with blocked tubes had no options to get pregnant. IVF makes conception possible.

IVF treatment involves taking fertility drugs to stimulate the ovaries. Then, using an ultrasound-guided needle through the vaginal wall, your doctor retrieves the eggs directly from the ovaries. In the lab, the eggs are put together with sperm from the male partner or a sperm donor. Hopefully, some of the eggs fertilize and some healthy embryos result. One or two healthy embryos are chosen and transferred to the uterus. 

IVF completely avoids the fallopian tubes so blockages don't matter. That said, research has found that an inflamed tube can significantly decrease the odds of IVF success. If you have a hydrosalpinx (fluid-filled tube), your doctor may recommend surgery to remove the tube. Then, after recovering from surgery, IVF can be tried. 

Tubal Ligation Reversal

Tubal ligation surgery is a “permanent” form of birth control. There are different kinds of tubal ligation. Possibilities include a surgeon cutting the tubes, “banding” them, clamping them, or placing specialized coils inside them. The idea is to intentionally block the fallopian tubes so the sperm can’t reach the egg.

A significant number of women later regret “getting their tubes tied”—anywhere from 20 to 30 percent. The good news is that even though this kind of birth control is considered permanent, it can be reversed for many women. Surgical repair of a tubal ligation is more likely to be successful than women having tubal surgery to repair disease-based blockages. Micro-surgical repair is often less expensive than IVF, costing as much as half per delivery.

Success rates are generally excellent for micro-surgical tubal reversal. For women younger than 40 years of age, pregnancy rates after two years are 90 percent. For women over age 40, success rates vary between 40 and 70 percent.

However, surgical repair isn’t always the best option. Situations that may be better for IVF include the presence of significant scaring, moderate to severe endometriosis, or moderate to severe male factor infertility. Your doctor can help you review whether surgical repair or going straight to IVF would be best for your situation.

Prevention

The majority of blocked fallopian tubes are caused by pelvic infections. Most—but not all—of these infections are caused by a sexually transmitted infection. Other possible causes (and risks) of pelvic infection include previous pelvic surgery, having a dilation and curettage (D&C), or complications after a miscarriage, abortion, or childbirth.

Regular screening of STIs, as well as getting worrisome symptoms checked out right away, is an important step in preventing tubal infertility. If the STI or pelvic infection is caught early enough, treating the infection may help prevent the development of scar tissue.

Symptoms to be aware of are…

  • general pelvic pain
  • pain during sexual intercourse
  • foul smelling vaginal discharge
  • fever over 101 (in acute cases)
  • nausea and vomiting (in acute cases)
  • severe lower abdominal or pelvic pain (in acute cases)

Acute pelvic infections can be life-threatening. If you have a high fever or severe pain, contact your doctor immediately, or go to the nearest emergency room.

However, often times, a woman doesn’t have any signs or symptoms of an infection. Most infections are not acute. “Quiet” doesn’t mean harmless. The longer the infection is present, the higher the risk of scar tissue forming and creating inflamed tubes.

Once an infection has been detected, quick antibiotic treatment is important. Treating the infection doesn’t guarantee the tubes will be clear. The antibiotics can only kill the bacteria. Any damage or scar tissue that has formed will not be helped by antibiotic treatment. That said, treating the disease can help prevent further damage, and may make fertility treatment or later surgical repair more likely to succeed.

Using condoms and getting regular STI testing (especially if you engage in high-risk sexual behavior) is recommended to prevent fallopian tube damage from STI.

A Word From Verywell

When just one fallopian tube is blocked, getting pregnant on your own or with low-tech treatments may be a possibility. However, when both tubes are blocked, surgery or IVF treatment may be your only options. Surgery may be covered by insurance, but IVF treatment rarely is. The high cost of IVF prevents many couples with this cause of infertility from being able to have a baby.

Talk to your doctor about all your options. If IVF or surgery isn't possible for you, you may want to consider adoption, foster care, or choosing to live a child-free life. Make sure you also have emotional support as you navigate this situation. 

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