The journey toward pregnancy is one filled with triumphs and disappointments, and for parents who’ve been trying to conceive for a while, nothing can be more frustrating than another negative test.
If you’re one of those potential parents beginning to question the cause of your conception conundrum, you may be aware of a growing number of new medical conditions and be wondering just how big a fight you’re up against.
Today, let’s talk about one of the most common causes of female infertility — blocked fallopian tubes.
What are blocked fallopian tubes, and how do they impact fertility?
Fallopian tubes, the organs which connect the uterus and the ovaries, play an important role in the reproductive process.
Not only do they provide safe passage for an egg to travel into the uterus where it can implant, but they’re also where the sperm and egg meet for potential fertilization — the all-important conception.
If an egg is fertilized within the fallopian tube, it will proceed to the uterus and try to implant in the uterine wall. However, if the fallopian tubes are blocked, it can be difficult or impossible for sperm to reach the egg, or for a fertilized egg to reach the uterus.
The degree to which blocked fallopian tubes will impact your fertility depends on the severity of the condition. If both of your tubes have a full blockage, it won’t be possible for you to conceive without treatment.
If you have a partial blockage in both of your tubes, the potential for pregnancy exists, but this condition raises the chances of a dangerous ectopic pregnancy; one in which a fertilized egg implants in the fallopian tube.
When this condition exists, your doctor might suggest the use of IVF in order to possibly bypass the blockage.
In less serious cases, where only one fallopian tube is blocked, chances are that you’ll get pregnant without realizing a problem exists. [mfnFallopian tubes: Is pregnancy possible with only one?]1mayoclinic.org/diseases-conditions/female-infertility/expert-answers/pregnancy/faq-20058418
However, if you’re still having trouble conceiving, your doctor may prescribe a fertility drug in order to improve your chances.
Fallopian tube blockage: symptoms, causes, diagnosis, and treatment
Aside from the inability to conceive, you may not actually notice the physical symptoms of your blocked fallopian tubes.
It’s often an unsuccessful attempt to get pregnant which makes women aware of the condition, and it can do so for years while remaining asymptomatic.
While it’s common for women to remain unaware of this blockage, some will experience a low-grade but consistent pain on one side of the abdomen.
This can be caused by a hydrosalpinx or a fallopian tube blockage that causes the tube to bloat and swell with fluid, putting pressure on surrounding organs.
If your blocked fallopian tube was caused by a health condition, you may experience symptoms related to that condition.
Endometriosis is a common female health concern that’s linked to blocked fallopian tubes. It involves the displacement of expelled uterine tissue, which can create scarring, cause pelvic pain, and increase the likelihood of a fallopian tube blockage.
What causes blocked fallopian tubes?
Ectopic pregnancy: Past experiences with ectopic pregnancy, a condition in which a fertilized egg begins to develop inside the fallopian tube, can create scar tissue within the tube that acts as a blockage.
Fibroid growth: Uterine fibroids, which can develop in or around the uterus, can create a fallopian tube blockage which is likely to occur at the point where the tube connects to the uterus.
Endometriosis: This painful condition, which can trigger heavy bleeding and severe menstrual cramps, occurs when the tissue that’s supposed to comprise the uterine lining grows in other places — most commonly the fallopian tubes, ovaries, and other pelvic tissue. This abnormal growth can create scarring which may block fallopian tubes.
Surgical scars: If you’ve had pelvic surgery, particularly if the surgery involved your fallopian tubes, scar tissue from your procedure may create a blockage.
Pelvic inflammatory disease: This fairly common infection of the female reproductive system, when left untreated, can create scar tissue that blocks the fallopian tubes. It’s also the condition most commonly associated with hydrosalpinx, a fluid-filled fallopian tube.
Tuberculosis: Genital tuberculosis mostly involves fallopian tubes in all cases and is, therefore, an important cause of tubal blockage.
Diagnosing blocked fallopian tubes
If a doctor suspects that you may have blocked fallopian tubes, they will use a type of x-ray called hysterosalpinography,2Simpson Jr, W. L., Beitia, L. G., & Mester, J. (2006).Hysterosalpingography: a reemerging study. Radiographics, 26(2), 419-431.
acog.org or HSG, to view the inside of your fallopian tubes.
In order for the x-ray to succeed, a dye must be introduced to your reproductive organs. Then, fluid is introduced into the area.
The motion of this fluid is then monitored in order to identify fallopian tube blockage. The best time to perform HSG is after the period is over, (i.e., days 6-12) when the endometrium is thinnest.
This will help better visualize the uterine cavity, as there are fewer chances of pregnancy at this time. The process, from start to finish, is as follows:
- The procedure begins much like a pelvic exam. You sit reclined, legs spread, and your doctor will open your vagina with a speculum and clean your cervix. You will be injected with local anesthesia.
- Dye is then inserted into the cervix. There are two ways in which this can be done — a cannula, or thin tube used to administer medication or fluid as the cervix is held still, or a thin plastic tube which uses a small inflated balloon to stay in place within the uterus.
- The doctor will then remove the speculum for the purposes of taking the x-ray. You’ll be moved beneath an x-ray machine, and the fluid used to make your diagnosis will be inserted through the tube. This fluid will fill your uterus and fallopian tubes, and may cause cramping. If you have blocked tubes, they will swell with fluid. As this takes place, multiple images will be taken by your technician. Changes of position may be required.
- After the x-rays have been obtained, the tube or cannula will be removed from your cervix. Expect some draining and discharge in the days following, especially among women with blocked tubes. Most of the fluid will be absorbed back into the body if your tubes aren’t blocked.
Do natural cures for blocked fallopian tubes work?
The truth is that, if your tubes are blocked, achieving pregnancy without surgical intervention can be difficult and sometimes dangerous.
If only one fallopian tube is blocked, you may not notice a drastic impact on your fertility, though your doctor may recommend and prescribe a fertility medication if the condition is diagnosed.
However, when both tubes are partially or fully blocked, ectopic pregnancy becomes a concern.
There is no known non-surgical cure for blocked fallopian tubes, and claims that dietary changes can reduce tubal inflammation haven’t yet been scientifically proven to help women with blockages become pregnant.
- While you can’t cure blocked fallopian tubes through lifestyle changes, doctors and experts recommend the following efforts to boost chances of conception:
- A diet centered around healthy, fertility-boosting foods that switches unhealthy fats for healthier picks like olive, coconut, or grapeseed oils
- Regular exercise and physical fitness
- Prenatal vitamins and supplements
- Stopping chemical birth control as soon as possible, pre-TTC
- Skipping alcohol and drugs (caffeine and nicotine included)
- Avoiding the use of lubricant during sexual activity
- Avoiding stress, which is hard on the body and affects your cycle
Treating blocked fallopian tubes
If your HSG reveals blocked tubes, your doctor will likely consult with you about your options for treating the condition.
Surgery is usually the suggested option if couples would prefer to avoid the cost and stress of IVF, though the location, type, and severity of your blockage will determine both how effective surgery will be or what type will be needed.
Some surgery types can be performed laparoscopically, or through a very small and non-invasive incision, making recovery much easier.
The removal of a partial fallopian tube is called a salpingectomy. This procedure is performed to increase the success rates of in-vitro fertilization in the event that a hydrosalpinx has developed.
The presence of a hydrosalpinx reduces the success rates of IVF by half. A salpingectomy is preferred for IVF patients over a salpingostomy.
When one end of a fallopian tube has been blocked by the presence of a hydrosalpinx, a salpingostomy is performed to create a new opening for the egg to travel through.
However, this procedure comes with a high risk of scar tissue regrowth in the affected area, hence its less-preferential status.
If the end of the fallopian tube that’s near the ovary is where the blockage exists, a fimbrioplasty may be performed. This helps to repair the end of the tube and facilitate the process of egg pickup from the ovary.
When the tubal blockage is directly next to the uterus, a surgery called selective tubal cannulation can be used.
A cannula, or catheter, is inserted through the cervix into the uterus and through the fallopian tube to dilate the opening. This surgery is guided using fluoroscopy or hysteroscopy.
Reversing your tubal ligation
If you’ve previously had a tubal ligation, or had your “tubes tied” to prevent pregnancy, the procedure will need to be reversed before you can get pregnant.
The kind of tubal ligation you had will determine how complex it may be to restore your natural fertility, or if it will actually be possible.
If you had a tubal ligation procedure that used a clip or ring to prevent the egg from reaching the uterus, a successful reversal should be fairly simple.
On the flip side, if a system that uses scarring was used, such as the Adiana or Essure system, getting pregnant without IVF might not be possible.
The surgical procedure used to reverse a tubal ligation, which is also used to repair portions of a fallopian tube that have been scarred by disease, is called a tubal reanastomosis.
After the scarred or damaged portion of the tube is removed, the two healthy ends are joined together. Sometimes, this surgery can be performed laparoscopically.
Ultimately, your doctor should be able to advise you of how successful a tubal ligation reversal would be in your situation and how the procedure would have to be performed.
Your age, BMI, and quality of sperm and egg cells also play a role in fertility after tubal ligation.
Blocked fallopian tubes account for around 20 – 40% cases of female infertility, so it’s very important to consult a fertility specialist to assess your situation and get the appropriate treatment.
The bottom line
Getting pregnant with blocked fallopian tubes can be difficult, though, in many cases, it’s possible with surgical intervention.
A visit to a fertility specialist for HSG tests can diagnose the presence of a blockage, and your doctor will be able to best advise you on what procedure, if any, will be necessary to restore fertility.
It’s always wise to live a healthy lifestyle while trying to get pregnant, so remember to take great care of yourself while, perhaps, relying on professionals you can trust to help you with this.