Fallopian Tube Blockage Treatment

Key Takeaways

• Fallopian tube blockages occur when inflammation or scar tissue blocks one or both tubes connecting the ovaries to the uterus. This condition can lead to a type of infertility called tubal factor infertility.
• Some of the most common tube blockages are caused by bacterial infections, surgical complications, endometriosis, and ectopic pregnancies.
• A blocked fallopian tube can lead to infertility, but fertility care experts are trained to treat blockages and still achieve pregnancy – typically through surgery or In Vitro Fertilization (IVF).

What Is a Fallopian Tube Blockage?

Fallopian tube blockages, also known as tubal factor infertility, affect a significant number of individuals. According to the American Society for Reproductive Medicine, tubal issues account for approximately 25% to 35% of female infertility.Fallopian tubes play a crucial role in your reproductive journey. Think of them as the conveyor belts between your ovaries – where eggs are produced – and your uterus, where a fertilized egg can nestle and grow into a potential baby. It’s within these delicate tubes that fertilization occurs, making them essential to fertility.

If part of the fallopian tube is damaged, for example by surgery or an infection, it can become damaged or blocked by scar tissue. Usually, patients will not notice any symptoms, other than difficulty conceiving. Sometimes, however, a blocked fallopian tube can cause individuals to feel pain in the pelvis or stomach. This pain might happen around the time of their period, or it can be constant.

It’s also possible to have fallopian tube damage even when the tube is still open, decreasing its efficiency to result in a pregnancy. Fallopian tubes contain hundreds of tiny muscles that are responsible for physically transporting the egg from the ovaries to the inside of the uterus. Think of this similar to how your intestines function: it’s not enough for your intestines to be open – the muscles in them must work to move food through the system. In the same way, for fallopian tubes to work, these microscopic muscles have to function.

If they don’t work perfectly, it is less likely that the tube will be able to transport an egg into the uterus. So even mild damage to the tube that affects the functionality of egg transport can impact fertility – even in a tube that is demonstrated to be open. 

What Causes Damaged or Blocked Fallopian Tubes?

Fallopian tubes can become damaged or blocked in numerous ways. Some causes of a blockage include:

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) results from an infection caused by sexually transmitted bacteria. These bacteria can spread from the vagina to the upper reproductive organs, ultimately leading to scar tissue and tube blockage. Gonorrhea and chlamydia are the most common sexually transmitted infections that lead to tubal factor infertility, according to a 2022 study.

Endometriosis

Endometriosis affects around 1 in 10 women of reproductive age, making it incredibly common. Ordinarily, the lining of the uterus (endometrium) thickens during the menstrual cycle to prepare for pregnancy. If pregnancy doesn’t occur, this lining sheds during your period.

With endometriosis, however, tissue similar to the endometrium grows outside the uterus, where it doesn’t belong. It can appear in the ovaries, fallopian tubes, and other areas in the pelvis. The endometrium tissue causes irritation and inflammation since it can’t be shed, sometimes scarring and blocking the fallopian tubes. Other symptoms of endometriosis can include pelvic pain, pain during intercourse, irritation while urinating, and heavy periods. 

Pelvic Surgery

Following pelvic surgery, fallopian tube blockages can occur as a result of scar tissue forming. This can happen especially after procedures to remove ovarian cysts as well as diseased tissue from endometriosis.

Ectopic Pregnancy

An ectopic pregnancy happens when an embryo attaches and develops outside of the uterus. According to the American College of Obstetricians and Gynecologists, almost all ectopic pregnancies – more than 90% – occur in a fallopian tube. As the pregnancy grows, it can cause the tube to burst. This rupture can be a life-threatening emergency requiring immediate surgery due to major internal bleeding.Getting pregnant after an ectopic pregnancy is oftentimes difficult, since the fallopian tubes often become damaged, scarred, or blocked.

Fallopian Tube Blockage Treatment Options

The good news is that fallopian tube blockages can be addressed in several ways by your fertility doctor, typically through surgery to repair the tube, selective tubal cannulation, or In Vitro Fertilization (IVF). We explain these options below.

Surgical Repair

Through laparoscopic surgery, your fertility doctor can remove small amounts of scar tissue or adhesions, opening blocked fallopian tubes. However, if extensive scar tissue exists, surgical removal may not be effective.

Selective Tubal Cannulation

For blockages closer to the womb, a procedure called selective tubal cannulation may be an option. In this procedure, a thin tube called a cannula is inserted through the cervix, uterus, and fallopian tube to open the blocked segment. This procedure may be done either in the office or in a surgical setting.  

In all cases of procedural tubal repair, the tubes rarely function perfectly. The fact that there was a tubal repair needed to begin with means that there was some damage to the tubes. Surgery can help optimize the anatomy, but it cannot restore perfect function to the hundreds of microscopic muscles that comprise the “conveyor belt” that moves eggs through the system. Therefore, following surgical repair, it is common to still have difficulty conceiving or have an elevated risk of ectopic pregnancy when a pregnancy is achieved. 

IVF

When surgical repair is unlikely to succeed, IVF can offer an effective alternative. IVF bypasses the fallopian tubes altogether, allowing fertilization to occur outside the body. Even if a patient’s tubes have been tied, IVF may still be an option to achieve pregnancy.

The American Society for Reproductive Medicine recommends weighing numerous factors when deciding between corrective surgery versus IVF. These include the patient’s age, number and quality of eggs (ovarian reserve), number of previous successful pregnancies, number of children the patient would like, any fallopian tube damage or blockage, other infertility factors that exist, and more. Additionally, a semen analysis should be ordered as part of a patient’s initial infertility evaluation, as the results may affect which treatment option to pursue.

Contact a Fertility Care Expert

Facing infertility can be emotionally challenging. It’s important to seek expert guidance, connect with support groups, and remember that you’re not alone. If you are having difficulty conceiving or suspect you may have damaged fallopian tubes, contact our board certified fertility care experts at SDFC for a personalized consultation. Together, we can evaluate treatment options that would work best for your unique journey.

This article provides general information and should not replace personalized medical advice. Consult your fertility care specialist for individualized recommendations.