Blocked or Damaged Fallopian Tubes and Infertility

A common cause of female factor infertility is a blocked or damaged fallopian tube. According to the American Society for Reproductive Medicine (ASRM), tubal factors and factors affecting the peritoneum (the lining of the pelvis and abdomen) account for about 35% of all infertility issues. 

The fallopian tubes are two thin tubes on each side of the uterus. A mature egg from the ovaries must travel through these tubes to reach the uterus, where it can be fertilized and implanted into the uterine wall. If the fallopian tubes are damaged or blocked, the odds of conception are significantly decreased. 

The fallopian tubes may also be only partially blocked, which increases the risk of an ectopic pregnancy. If the pregnancy is ectopic, it means that the fertilized egg has implanted outside of the uterus, usually in the fallopian tubes. These pregnancies are not viable and may lead to serious medical complications.

Causes of Blocked or Damaged Fallopian Tubes

The most common cause of damaged or blocked fallopian tubes is pelvic inflammatory disease (PID). PID is the result of a sexually transmitted infection that spreads from the vagina to the uterus and fallopian tubes. Other pelvic infections not related to STDs may also cause fallopian tube damage. Causes of blockages and other damage to the fallopian tubes include:

• Pelvic inflammatory disease (PID)
• Other pelvic infections
  • Current or history of an STD infection, specifically gonorrhea or chlamydia 
  • Uterine infection caused by miscarriage
• Endometriosis
• Uterine fibroids
• History of ectopic pregnancy
• Previous surgery involving fallopian tubes
• History of a ruptured appendix

Diagnosis

If your doctor suspects you have blocked or damaged fallopian tubes, they will order a test called a hysterosalpingogram (HSG). This is an imaging test done using a type of x-ray imager called a fluoroscope. The doctor uses a speculum and an instrument called a cannula to access the cervix and fill the uterus with a special contrast liquid that contains iodine. The doctor uses the fluoroscope to watch the liquid enter the fallopian tubes. In a healthy and open tube, the contrast will travel the length of the tubes and spill out of the end. If the tube is blocked or damaged, the contrast will not reach the end or spill out.

An HSG is an effective tool for helping physicians diagnose tubal factor infertility. It is also not as invasive as some other procedures and women usually only experience mild cramping for a short period before returning to normal activities. 

Treatment

IVF

In vitro fertilization (IVF) may make conception possible for women with blocked fallopian tubes. In fact, IVF was first developed for this exact purpose. Because the eggs are retrieved directly from the ovaries, the fallopian tubes are bypassed altogether. That is why IVF is usually the first treatment option for this type of female infertility. 

Surgery

If IVF alone is not a viable treatment for blocked or damaged fallopian tubes, surgery may be an option. Surgery is not right for every woman, so you should talk with your doctors about the risks and benefits of each procedure. Often, these surgeries are performed laparoscopically through small incisions in the abdomen. The following surgeries can improve the chances of conception through IVF:

• Partial salpingectomy: The damaged part of the fallopian tube is removed to improve the chances of successful IVF. This procedure is often performed when there is a buildup of fluid within the tube.
• Salpingostomy: When the blockage is at the end of the fallopian tube, this procedure can be done to create a new opening in the tube. There is a risk of scar tissue regrowing and covering the new opening, which will block the tube again.
• Fimbrioplasty: In this procedure, the damaged parts of the fallopian tubes are repaired or reconstructed. This is preferable to a salpingostomy, as there is less risk of scar tissue growth.

The expert team at Laurel Fertility Care is dedicated to helping you come up with a plan to grow your family that works for you. We take each patient’s individual circumstances into account when planning fertility treatments. To get started on your fertility journey, call us at (415) 673-9199 to make an appointment.