The journey toward pregnancy is one filled with triumphs and disappointments, and for parents who’ve been trying to conceive for a while, little is more frustrating than another negative test.
If you’re among the potential parents who are beginning to question the cause of your conception conundrum, you’ve likely learned about a large handful of new medical conditions, and may be wondering just how big a fight you’re up against. Today, we’re going to 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 1 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 bypass the blockage, if possible.
In less-serious cases, where only one fallopian tube is blocked, there’s a good chance you’ll be able to 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 are 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
The symptoms of blocked fallopian tubes
Aside from the inability to conceive, you may not actually notice physical symptoms of your blocked fallopian tubes. It’s often an unsuccessful attempt to get pregnant which makes women aware that the condition exists, as it can do so for years while remaining asymptomatic.
While it’s common to not realize the blockage exists, some women will experience a low-grade but consistent pain on one side of their abdomen. This pain is common to a hydrosalpinx, a fallopian tube blockage that can cause a 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 one common female health concern that’s linked to blocked fallopian tubes, as 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; it’s particularly 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. The 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 gone 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 therefore an important cause of tubal blockage.
Diagnosing blocked fallopian tubes
If your 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 be successful, dye must be introduced to your reproductive organs. Then, fluid is introduced to the area. The motion of this fluid is observed in order to identify fallopian tube blockage. The best time to do HSG is , after the period is over. i.e., (days 6-12), when the endometrium is thinnest. This will help in better visualization of the uterine cavity and there are very less chances of pregnancy at this time. The process, from start to finish, is as follows:
- The procedure begins much like a pelvic exam — you’ll 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, which is a 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. You should expect to have some draining and discharge in the days following, though this is more significant for women who have 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 of the matter is that if your tubes are blocked, achieving pregnancy without surgical intervention can be difficult and 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 been scientifically proven to help women with blockages get pregnant.
- While you can’t cure blocked fallopian tubes through lifestyle changes, doctors and experts recommend the following efforts to boost chances at 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
- Introducing 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
- Getting away from 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 almost always 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 and what surgery will be needed. Some surgery types can be performed laparoscopically, or through a very small and non-invasive incision, which makes 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 cuts the success rates of IVF in 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 the area 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 are 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 restoring your natural fertility will be, or if it will be possible.
If you had a tubal ligation procedure that used a clip or ring to prevent the egg from reaching the uterus, successful reversal may 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 a possibility.
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 will be able to give you the best idea of how successful a tubal ligation reversal would be in your situation and how the procedure would need to be performed. Your age, BMI, and the 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 is very important to consult a fertility specialist for assessment of your situation and get the treatment accordingly.
The bottom line
Getting pregnant with blocked fallopian tubes can be difficult, but 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 practice a healthy lifestyle when trying to get pregnant, so remember to take great care of yourself and rely on professionals you can trust for assistance with this.