Blocked Fallopian Tubes
What is Blocked Fallopian Tubes?
In the female reproductive system, fallopian tubes are the connection between the ovaries and the uterus. The fallopian tubes work for carrying the egg from an ovary to the uterus during ovulation. It happens every month in the middle of a menstrual cycle. The occurrence of conception happens in the fallopian tube.
The meeting of an egg with sperms happens in the fallopian tube and is known as fertilization. After fertilization of the egg, the embryo goes to the uterus through the fallopian tube. The fallopian tube is the passage for meeting the egg and sperm, and also the way to the uterus for the fertilized egg. If the passage gets blocked, it will disrupt the whole procedure. The scar tissues, pelvic adhesions, and infection are the reason behind the blockage of the fallopian tube.
Causes of the blocked fallopian tube
Scar tissues block fallopian tubes and there are many reasons behind blocked fallopian tubes. These are as follows:
- Pelvic inflammatory disease can cause scarring.
- In the fallopian tube, endometriosis can build up endometrial tissues, which are the reason for the blockage. On the outside of a fallopian tube, endometrial tissue can develop on other organs like the ovary and lead to scarring, fibrosis and cause a blockage.
- Gonorrhea and Chlamydia are some sexually transmitted infections that can cause scarring. It can lead to pelvic inflammatory disease.
- Past ectopic (tubal) pregnancy can scar the tubes.
- The growth of fibroids can cause blockage between the paths where the uterus is attached to the fallopian tubes.
- If someone has a history of abdominal surgery or surgery on fallopian tubes can cause blockage of the tubes because of pelvic adhesions.
Including these, there are other reasons behind the blockage of tubes.
Symptoms of Blocked Tubes
Blocked fallopian tubes do rarely present symptoms other than difficulty in conceiving. Doctors say this when someone has tried to conceive for 1 year without success. Blocked fallopian tubes may cause some other symptoms, like feeling pain in the belly or the pelvis. This pain can be sometimes felt during periods, or it can also be constant.
In some serious cases, a blockage in one of the fallopian tubes can cause a fertilized egg to get stuck and result in an ectopic pregnancy. According to a survey, a blocked fallopian tube may make getting pregnant difficult. But if one fallopian tube is blocked, it may still be possible for an egg to be fertilized. If both are blocked, this is less likely to happen.
Diagnosis of blocked fallopian tubes
The diagnosis of blocked fallopian tubes can be difficult. Medically, both the tubes can be open or close sometimes, so it is difficult to tell if they are actually blocked or just closed.
There are three major tests to diagnose the blocked fallopian tubes:
- An X-ray test, hysterosalpingogram or HSG, is a test that tells about the blocked fallopian tubes. For this test, the doctor injects a harmless dye into the uterus that goes and flows into the fallopian tubes. If this happens, we can see a stain on an X-ray. But if the fluid or the dye does not flow into the tubes, this shows that the tubes are blocked
- An ultrasound test or a sonohysterogram is very similar to the HSG test, but it uses sound waves in order to build up a picture of the fallopian tubes on the computer screen.
- Keyhole surgery also called laparoscopy is a surgery where a surgeon makes a slight cut in the body and inserts a tiny tube that has a camera to examine fallopian tubes by taking its pictures.
For diagnosing blocked fallopian tubes, a laparoscopy is the most specific test. However, sometimes the doctors may not recommend this type of test as an early diagnosis of it because it is invasive and cannot treat the problem.
Blocked fallopian tubes and pregnancy
A blocked fallopian tube is one of the common causes of infertility in women. For a pregnancy to happen, an egg and a sperm meet in the fallopian tube for fertilization. But, if there is a blockage in the tube, the fertilization can not take place, making it harder for women to conceive.
Now, if one tube is not blocked, there are chances that pregnancy could happen. The fertilization can take place in the unaffected fallopian tube But, if both the fallopian tubes are blocked, then treatment is required to conceive.
The first treatment option is doing surgery. This surgery aims to open up the blockage in the fallopian tubes to increase the chances of conceiving. Now, to say if surgery can really help a woman conceive depends upon various things like:
- her age
- the health of her partner’s sperm
- the level of fallopian tube damage
If this surgery went unsuccessful, the doctor may recommend in vitro fertilization (IVF). IVF involves placing the fertilized eggs directly into the uterus so that the fallopian tubes are not involved in conceiving.
Treatments for blocked fallopian tube
Doctors use laparoscopic surgery for removing the blockage and opening the tubes, only if you are having small amounts of scar tissue or adhesions in the fallopian tubes. On the other hand, the treatment of removing large amounts of scar tissue or adhesions from the fallopian tube is not possible.
If the ectopic pregnancy causes damage to the tubes, doctors can opt for surgery. When the fallopian tubes get damaged because of the blockage, the doctor can connect the healthy parts by removing the damaged portion.
The treatments that the doctors perform to repair the fallopian tubes are:
- If your fallopian tubes are blocked, the doctor can opt for Fallopian Tube Recanalization (FTR) which is a surgical procedure in which laparoscopy and hysteroscopy are combined and done. This process includes minor cuts on the tummy to introduce a laparoscope. To keep your vagina open, they will use a tool named speculum and will insert the hysteroscope. A fine catheter is inserted into the uterus through the cervix. After this procedure, they will inject methylene blue dye through the catheter and visualize the fallopian tube and uterus.
It helps them to check the condition of blockage. To execute the last step of clearing the blockage, they will choose a smaller catheter which is passed along the hysteroscope via the uterus up to the fallopian tube opening in the uterus known as tubal Ostia. The fine catheter is passed through the tubal Ostia into the tube. This procedure is sometimes useful for clearing a tubal blockage.
- Tubal Ligation Reversal Surgery applies to patients who had a history of cutting fallopian tubes for preventing pregnancy. They can opt for this procedure to undo it. In this process, the doctors give general anesthesia and will make a small cut in the abdomen to reconnect the parts of the tubes. After performing this surgery, eggs will get to travel through fallopian tubes. But the successful outcome of pregnancy largely depends on the length of the tube available for recanalization.
- Salpingostomy is another process of removing blockage of the fallopian tube where the tube is filled with fluid and the condition is known as hydrosalpinx. In this procedure, the doctor will give a small cut to open the blocked and swollen end of a tube, which is filled with fluid and will leave the tubes in place after removing the blockage. They will let it heal naturally. Neosalpingostomy and fimbrioplasty are other names of this procedure.
- Salpingectomy or Tubal Clipping is another procedure done for treating Hydrosalpinx. During salpingectomy, doctors remove the fallopian tubes whereas, during clipping, the doctor either ties a knot or cuts or clips the tube to disconnect the fluid-filled tube (Hydrosalpinx) from the uterus. This process increases the chances of getting pregnant by in vitro fertilization.
The major cause of infertility is the blockage of fallopian tubes. The connection between the ovaries and the uterus is the fallopian tubes which are female reproductive organs. The fallopian tubes work for carrying the eggs from the ovary to the uterus in the middle of the menstrual cycle. If sperm fertilizes an egg, for implantation the embryo goes to the uterus through the fallopian tubes.
So, these tubes are the passage for the sperm to connect with eggs but if the passage gets blocked, the path of the egg fertilization gets blocked. Infections, pelvic adhesions, and scar tissues are reasons behind the blockage of the fallopian tubes.
Generally, it does not have symptoms and women also do not get to know about it until they face issues in getting pregnant. Pain in one side of the abdomen can be a symptom of blocked fallopian tubes. The doctors recommend the patients go for in vitro fertilization or else they need to do treatment for it to get pregnant.
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Dr. Pradyot Kumar is the CEO of Gunjan IVF World. He is a Neurosurgeon with specialization
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Dr Ankita Nigam, MS
MS Obs & Gynae (Gold Medallist). Dr Ankita Nigam has 3+ years of experience in IVF, Infertility and Gynaecology. She conducts and assists in OPD at our Indirapuram and Meerut centres. She actively assists IVF consultants in all procedures. She takes care of the management of various IVF, Infertility, Pregnancy care patients. She has done a special training in "Ultrasound Whole abdomen and Obstetrics & Gynaecology" from Thomas Jefferson University Philadelphia US.
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