The Symptoms, Causes, Diagnosis and Treatment of Blocked Fallopian Tubes
What is the function of Fallopian Tubes?
The beginning of pregnancy takes place in the fallopian tube. Fallopian tubes are the tubal structures that connect a woman’s ovaries to her uterus. Fully functional fallopian tubes are extremely important to a woman’s ability to become pregnant and are where sperm and eggs initially meet before an embryo later travels to attach to the uterus.
The fallopian tubes are attached to the uterus (womb) on the left and right sides. Normally, the fallopian tube picks up an egg as it is released (ovulated) from the ovary each month, and this is usually where sperm and egg meet. Sperm travel from the vagina through the uterus and will eventually meet the egg in one of the two tubes. Fertilization is when the egg and sperm join together to form an embryo (fertilized egg). The embryo travels through the tube into the uterus. When it reaches the uterus, it can start attaching to the wall of the uterus and develop into a baby.
How do blocked fallopian tubes affect pregnancy?
The fallopian tubes are vital to the proper function of the female reproductive system. Women have two fallopian tubes, one connecting each ovary on each side of the uterus.Each month a mature egg is released from the ovary in a process known as ovulation. The egg travels into one of the fallopian tubes, where it joins the male sperm for fertilization. The resulting embryo then travels through the tube to the uterus to implant for pregnancy.
When one or both tubes are blocked, it can cause infertility by either preventing the egg from being fertilized or preventing the resulting embryo from traveling to the uterus. Blocked fallopian tubes can also result in complications like ectopic pregnancy.
Most women are unaware that they have blocked fallopian tubes until they have difficulty conceiving, largely due to the fact that there are very few symptoms or indicators that the fallopian tubes are blocked. One of the most common reasons for blocked fallopian tubes is previous chlamydia infection, and 85 percent of women who’ve had this infection don’t realize they’ve had it.
A blocked fallopian tube is one of the most common reasons for subfertility (trying to conceive is taking longer than what is typically expected ) in young women and it is often missed by not being tested, or hysterosalpingograms (HSG testing) that did not identify disease that is present.
According to the American Society for Reproductive Medicine, tubal disease accounts for 25%– 35% of female factor infertility. When one or both of the woman’s fallopian tubes are blocked, it is known as tubal factor infertility.
Blocked fallopian tubes are a common cause of infertility. This is because it’s harder for a fertilized egg to move through a blockage to the uterus. In these cases, IVF can provide a potential alternative for a successful pregnancy.
Symptoms of blocked fallopian tubes
Blocked fallopian tubes don’t often cause symptoms. Many women don’t know they have blocked tubes until they try to get pregnant and have trouble. In some cases, blocked fallopian tubes can lead to mild, regular pain on one side of the abdomen. This usually happens in a type of blockage called a hydrosalpinx. This is when fluid fills and enlarges a blocked fallopian tube.
What causes blocked fallopian tubes?
Fallopian tubes can become blocked for a range of reasons, which include:
a history of pelvic infection
a previous burst appendix
having had a sexually transmitted disease, such as gonorrhea or chlamydia
endometriosis, a condition that causes the lining of the womb to grow outside of the uterus
history of abdominal surgery
hydrosalpinx, which is swelling and fluid at the end of a fallopian tube
All of these conditions can affect the fallopian tubes directly or this area of the body. In most cases, these conditions or procedures create scar tissue that can block the tubes.
Where does the egg go if fallopian tubes are blocked
If one fallopian tube is blocked, it’s still possible to get pregnant as the egg can travel through the other side of the body since there are two ovaries. However, if both tubes are completely blocked, it won’t be possible to get pregnant naturally until one or both is unblocked.If the fallopian tubes are partially blocked, you can potentially get pregnant. However, the risk of an ectopic pregnancy increases.
The most common complication of blocked fallopian tubes and treatment is ectopic pregnancy. If a fallopian tube is partially blocked, an egg may be able to be fertilized, but it may get stuck in the tube. This results in an ectopic pregnancy, which is a medical emergency.
Damage and blockage of the end portion of a fallopian tube can cause it to become filled with fluid; the swollen and fluid-filled tube is called a hydrosalpinx. A normal pregnancy in the uterus may not occur because the tube may be severely damaged and blocked and not work properly. A pregnancy may develop in the tube (ectopic pregnancy) which can be life-threatening. In addition, as the tube is blocked, secretions that collect in the tube may backflow into the uterus and prevent a pregnancy from implanting into the uterus.
What is an Ectopic Pregnancy?
Let’s start with the definition of the word Ectopic which means “in an abnormal place or position”. So, Ectopic pregnancy refers to when a fertilized egg implants outside of the uterus rather than in it, oftentimes within one of the fallopian tubes. Sometimes referred to as tubal pregnancy, ectopic pregnancies are sometimes the result of blocked fallopian tubes.
Diagnosing blocked fallopian tubes
Traditional methods for identifying whether the fallopian tubes are blocked include hysterosalpingogram (HSG), sonosalpingography and minimally invasive laparoscopy.
Hysterosalpingogram (HSG) testing uses dyes and x-ray imaging technology to examine the uterus and fallopian tubes to see whether fluid travels through the fallopian tubes. This particular procedure can cause cramping, discomfort, and vaginal spotting and bleeding for up to 72 hours. Many women describe it as one of the most painful procedures they’ve ever had, with some even saying it was worse than childbirth. However, some women have minimal to no discomfort with HSG.
"Hysterosalpingography (HSG) is an X-ray procedure that is used to view the inside of the uterus and fallopian tubes. It often is used to see if the fallopian tubes are partly or fully blocked.
The doctor will inject a special liquid that shows up on an x-ray into your uterus through your cervix (neck of the womb) and then take an x-ray (called a hysterosalpingogram or HSG) to see where the liquid goes. If your fallopian tubes are open, the liquid will flow out of the ends of the tube into the pelvic cavity. If the tubes are blocked, the liquid will be trapped and your doctor will be able to tell that you have a hydrosalpinx. However, this test can sometimes falsely suggest that the tubes are blocked and sometimes results can be difficult to interpret.
As noted by Dr. Preston Parry, though HSGs have been performed on women for over 100 years, it is arguable how much that test has advanced over that time. The problem with the HSG test is it is often painful and not always conclusive.
Sonosalpingography is an approach that uses air infused saline and watches to see if it goes through the fallopian tubes through a 2-dimensional ultrasound. Though the technique has potential, many OB-GYNs and REIs (fertility specialists) don’t know how to perform it. Additionally, it can be just as painful as HSG, can often take a doctor 100-200 procedures to learn how to do it well, and can sometimes only give information about one fallopian tube.
Laparoscopy is a minimally invasive surgical procedure in which a small instrument outfitted with a camera (laparoscope) is inserted through a small incision on the belly to examine the organs.
During this surgery, the doctor can look at your fallopian tubes to see if they are blocked. Usually the doctor inserts a dye through the cervix into the uterus and fallopian tubes to confirm that the dye passes through the ends of the tubes.
This procedure is often considered to be the most accurate test. However, it is a surgical procedure and is often seen as a last result because of incisions, anesthesia, high cost and a postoperative recovery period.
A better alternative to HSG Testing
Blocked fallopian tubes can be difficult to identify and are often accompanied by one symptom: the inability to become pregnant. At Positive Steps Fertility, we have pioneered a new patented fertility testing technique called the Parryscope®.
Invented by Dr. John Preston Parry, the Parryscope approach, can gently evaluate whether there are any blockages in the fallopian tubes, the health of the ovaries, the number of eggs remaining, and the condition of the uterus in one 15-minute office procedure.
The Parryscope® fertility diagnostics approach is an fast and less painful alternative to traditional methods of diagnosing infertility and identifying fallopian tube blockages and can pick up problems that other tests might miss.
Our studies show that HSG was 110 times more likely to cause women maximum pain measures, compared with the Parryscope technique. Our patented Parryscope technique also doesn’t use radiation and our results suggest a reduced risk of infection and tissue abrasion.
Causes of Blocked Fallopian Tubes
Pelvic inflammatory disease (PID) is one of the leading causes of blocked fallopian tubes.
PID is a serious infection that develops when certain sexually transmitted diseases (STDs) or other infections aren’t treated. This can cause irritation and scarring that blocks fallopian tubes or puts women at higher risk of other forms of infertility.
Endometriosis effect on Fallopian Tubes
Endometriosis can cause tubal-factor infertility in two ways: excess, misplaced tissue can block the fallopian tubes, and excess tissue or the surgical removal of that tissue can scar the fallopian tubes. Endometriosis can also cause damage to an ovary through inflammatory effects, as well as trauma to the ovary when trying to remove endometriomas, which occur when endometrial tissue gets trapped inside an ovary.
Endometriosis is a disorder in which tissue similar to that which grows inside the uterus during a woman’s menstrual cycle grows outside of the uterus, often on or within other organs. It can be quite painful and is one of the top three causes of infertility in women. Endometriosis can be difficult to diagnose, partly due to the fact that its symptoms are similar to many other reproductive disorders. Endometriosis symptoms include:
Painful bowel movements.
Severe abdominal pain.
Lower back pain.
Heavy periods or spotting between periods.
Additional causes of Blocked Fallopian Tubes
Pelvic inflammatory disease, endometriosis and complications from previous ectopic pregnancy are just a few factors that can place women at risk of tubal factor infertility. Other causes of blocked fallopian tubes include:
Scarring from previous surgeries.
Damage from ruptured appendix & repair.
Fallopian tube blockage can not only put a woman at increased risk of ectopic pregnancy, but can also be caused by an ectopic pregnancy. Reproductive technology can help women with tubal blockages or women who have had tubal ligation in the past to become pregnant.
Blocked Fallopian Tubes Treatments
If your fallopian tubes are blocked by small amounts of scar tissue or adhesions, your doctor can use laparoscopic surgery to remove the blockage and open the tubes. If your fallopian tubes are blocked by large amounts of scar tissue or adhesions, treatment to remove the blockages may not be possible.
Surgery aims to open the fallopian tube using one of the following methods:
removing scar tissue
making a new opening on the outside of the fallopian tube
opening the fallopian tube from the inside
Treatment options include
Fallopian Tube Recanalization (FTR)
Fallopian tube recanalization (FTR) is a nonsurgical procedure to clear blockages in the fallopian tubes, part of a woman’s reproductive system.
Salpingectomy is the surgical removal of a fallopian tube. Salpingectomy is different from salpingostomy (also called neosalpingostomy).
Salpingostomy is the creation of an opening into the fallopian tube, but the tube itself is not removed in this procedure.
The term fimbrioplasty is often used instead of salpingostomy (ie, simply opening the fallopian tube) because salpingostomy does not address the important role of the fimbriae. Reconstruction that preserves the delicate fimbriae is important for fertility outcomes. The purpose of fimbrioplasty is to open the obstructed fallopian tube and salvage enough function of the fimbriae to allow successful entrapment and transportation of the oocyte.
IVF Treatment for Blocked Fallopian Tubes
In vitro fertilization (IVF) is often used to treat infertility caused by tubal disease. IVF is the only treatment available for severely damaged, inoperable fallopian tubes and for situations in which tubal disease is concurrent with another fertility factor.
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