Blocked Fallopian Tubes: Types, Causes And Treatments

Many women experience problems in conceiving. While there are numerous causes for infertility, the blockage in the fallopian tube is one of the most common reasons. In 20% of female infertility cases, a blocked fallopian tube is the leading cause. Before we delve more into this subject, let us know more about fallopian tubes.

• What Are Fallopian Tubes?
• What Are Blocked Fallopian Tubes?
• Types Of Fallopian Tube Blockages
• Causes Of Blocked Fallopian Tubes
• How Are Blocked Fallopian Tubes Diagnosed?
• Can I Still Get Pregnant With A Fallopian Tube Blockage?
• Treatment For Fallopian Tube Blockage

What Are Fallopian Tubes?

Fallopian tubes are a pair of thin tubes that branch out (Fimbriae) to the pelvic cavity, one on either side of the uterus. At the utero-tubal junction, the fallopian tubes open to the uterine cavity. This portion of the fallopian tube is called isthmus
With the help of Fimbriae, an egg that is released by the ovary gets into the fallopian tube. From here begins the journey of the egg to the uterus. In between the journey, towards the middle of the fallopian tube, there is a section of the tube called Ampullary where fertilization of an egg takes place. If the egg is fertilized, it will get implanted in the uterine wall and develop into a fetus. Thus, the egg produced in the ovary reaches the uterus through fallopian tubes.

What Are Blocked Fallopian Tubes?

As the name suggests, a woman will have blocked fallopian tubes, if the tubes are obstructed due to some reason. It can happen to one or both the tubes. Likewise, the blockage can happen in any part of the tube. Different kinds of blockage can occur in fallopian tubes. In some cases, doctors have also diagnosed that there are diseases that may block certain parts of the tube more than the other parts.

Types Of Fallopian Tube Blockages

Based on the cause and location of the blockage, there are different types of blockages. Some of them are as under:

• Proximal tubal occlusion: This type of blockage occurs in the isthmus area. Proximal tubal occlusion usually happens because of an infection which can be due to any complications from a previous miscarriage, abortion or pelvic inflammatory disease (PID)
• Mid-segment tubal obstruction: As the name implies, this type of blockage happens towards the middle of the fallopian tube, towards the ampullary area. It happens as this area is more prone to tubal ligation damage
• Distal tubal occlusion: This type of blockage affects the end of the fallopian tube that opens into the ovary – the fimbriae area. Generally, distal tubal occlusion happens as an aftereffect of Chlamydia trachomatis infection which is a sexually transmitted disease
• Hydrosalpinx: This happens when some fluid gets filled within the fallopian tubes, giving them a sausage-like shape. This is usually followed by the closure of the tubes at the ends that open into the ovary
• Pyosalpinx: This type of blockage takes place when fallopian tubes are completely filled, and more often, bloated with pus
• Hematosalpinx: This is a health condition which involves bleeding in fallopian tubes resulting in the accumulation of blood and clots inside the tubes causing a blockage
• Chronic salpingitis: A bacterial infection and inflammation cause this in the fallopian tubes. The infection, if not treated promptly, will develop into acute salpingitis, where the inner wall of the fallopian tubes stick together and become red and swollen causing blockage and permanent damage to the tubes

Causes Of Blocked Fallopian Tubes

A blockage can happen in one or both fallopian tubes. Some of the causes of the blockage are:

• Pelvic inflammatory disease(PID): PID is one of the major causes of blocked fallopian tubes. PID refers to the collective inflammatory issues that affect the female reproductive system by creating blockage and damage to the fallopian tube. The fallopian tubes may be twisted, or the walls may get stuck together thus creating a total blockage
• A side effect of surgeries: Complications due to surgeries that involve the uterus and fallopian tubes like a C-section, abortion, etc. can cause a blockage
• Fibroids: A fibroid may bring about pressure on the fallopian tubes thus causing a blockage in the path of sperm or eggs
• Endometriosis: Endometriosis can cause a blockage. This is because the scars and adhesion that are created because of endometrial tissue can place physical pressure, obstructing fallopian tubes. This can prevent the tubes from taking in the eggs released from the ovary or making way for them to the uterus
• Infections: Infections, including sexually transmitted infection (STI) like chlamydia and gonorrhea or any infection caused by an abortion or miscarriage, can cause a blockage in the tubes
• Genital tuberculosis: Tuberculosis or TB can affect any part of the body. It mostly happens in the lungs (pulmonary tuberculosis). Sometimes the TB infection might pass to other parts of the body through the blood bringing about secondary infections. When the bacteria get as far as the genital tract, it develops genital tuberculosis or pelvic TB. The fallopian tubes are generally affected causing a tubal obstruction which is irreversible
• Ectopic pregnancy: Sometimes, instead of continuing to travel toward the uterus, the fertilized egg is implanted in fallopian tubes, resulting in tubal pregnancy. If the woman has already experienced an ectopic pregnancy, she develops an increased risk of scar formation leading to the blockage of fallopian tubes
• Ruptured appendix: If the woman has a history of a ruptured appendix, there is a chance that the infection can affect the fallopian tubes leading to blockage
• Tubal ligation removal: Tubal ligation, a popular birth control method, is removed when the couple desires for a baby. The chances for the fallopian tube blockage are high in this case because of the scar tissue that is formed after the procedure

How Are Blocked Fallopian Tubes Diagnosed?

If the doctor suspects a blockage in the fallopian tube, some test is undertaken to confirm the same. Some of the common tests used to diagnose blocked fallopian tubes are:

• Hysterosalpingogram: It is basically an X-ray test in which a thin tube is inserted through the vagina into the uterus. A dye is inserted from this tube, and the uterus is filled with the dye. This is done until the dye spills into the fallopian tubes. At this point, X-rays are taken to identify any blockage in the tubes
• Chromotubation: This is considered as one of the most reliable tests to determine blockage in the fallopian tube. In this test, a blue color dye is expelled into the uterus and fallopian tubes. This procedure is performed during laparoscopy where the doctors can actually see the dye spilling into the Fallopian tubes
• Sonohysterography: In this test, an ultrasound is performed to diagnose if there are any blockages in the fallopian tubes

Can I Still Get Pregnant With A Fallopian Tube Blockage?

A blockage in the fallopian tubes makes it difficult to conceive but not necessarily impossible. As mentioned above, women have a pair of fallopian tubes, i.e., there are two tubes, one for each ovary. If there is a blockage in one of the tubes, you can still get pregnant if the other side is in working order. However, if both the tubes are blocked, treatment is needed to resolve the blockage.

Treatment For Fallopian Tube Blockage

Blocked fallopian tubes can hamper a woman’s chances of getting pregnant. But with the advancement in medical technology, there are many treatment options available to unblock the fallopian tubes. A surgical procedure is an option for reopening the fallopian tubes. Depending on the location and how far the blockage is, different types of surgeries (either open or laparoscopic) are performed. Some of them are as below:

• Tubal re-anastomosis: The blocked or infected segment of the tube is removed, and two healthy ends of the tube are rejoined. This procedure is either done through a laparotomy, which involves a large incision in the lower abdomen or laparoscopy, in which a small keyhole incision on or near the belly button is done
• Salpingectomy: This procedure involves removing a part of the fallopian tube. It is usually performed in the case of Hydrosalpinx type of blockage. This is usually performed before going for IVF. This is because without treating Hydrosalpinx, the chances of success of IVF is very low
• Fimbrioplasty: This is performed when the fimbriae are damaged and stuck together, preventing the released egg from being picked up from the ovary. The purpose of the surgery is to rebuild fimbriae. The drawback is that there are very few experienced and expert specialist in this field
• Salpingostomy: This surgical method is suggested when Hydrosalpinx obstructs the end of the fallopian tube. The surgeon makes another opening near the end of the fallopian tube that opens to the ovary. The drawback is that the success of this method is often temporary and most probably the scar tissue regrows causing another blockage
• Tubal cannulation: This is a non-surgical procedure done without making any type of incision. A catheter is inserted through the cervix, uterus, and into the fallopian tube. This procedure is monitored with the help of an ultrasound. The doctor will know the exact location of the block, and when the catheter reaches there, the doctor opens up the block by blowing up a balloon in the catheter. Hysterosalpingography is performed prior to this procedure in which the doctor expels a dye through the catheter to identify the exact location of the block

So don’t lose heart if you are diagnosed with blocked fallopian tubes. Consult with your doctor and look for a treatment plan most suitable for you.