Fallopian tubes carry the egg from the ovary to the uterus. In most simplistic terms fallopian tubes form the pathway for the egg to travel from ovary to uterus and for sperm to swim up to the egg for fertilization. Sperms with their motile tails travel towards the egg, fertilization occurs in the fallopian tubes forming the embryo that travels to the uterus and gets implanted. Any hindrance in this route can prevent conception and pregnancy. Data suggests approximately 25% of infertility in women is due to fallopian tube blockage termed as “Tubal Factor Infertility”. Natural conception and safe pregnancy is possible even with a single patent functional tube. Partial obstructions or scars sometimes can lead to ectopic pregnancy, a condition where the developing embryo continues to stay and grow in the fallopian tube. This condition is extremely dangerous and such pregnancies are terminated as soon as detected.
What causes tubal blockage?
• Pelvic Inflammatory disease – Infections like Gonorrhea and Chlamydia can lead to accumulation of cellular debris and pus cells that can cause obstructions in the fallopian tubes.
• Surgery involving fallopian tubes – sometimes the fallopian tubes get entwined or damaged during surgical procedures that can temporarily or permanently block the tubes.
• Previous ectopic pregnancy – scars left after the medical termination of ectopic pregnancy may cause tubal blockage.
• Sexually transmitted disease – these infections can travel up to the uterus and fallopian tubes and cause damage to fallopian tubes.
• Abdominal surgery
Symptoms and diagnosis
Women with blocked fallopian tubes do not present with any symptoms and it is usually detected only during a fertility work up. However in women with severe blockage abdominal pain is observed. Tubal blockage is confirmed by HSG (Hysterosalpingogram) or by hysteroscopy. HSG is a specialized type of X-ray exam wherein a dye is introduced through the vagina and its migration and into the uterus and spillage from the fallopian tubes is tracked. Patent fallopian tubes allow the dye to flow through and X-ray shows a dye spillage, whereas in case of blocked tubes the dye does not flow through. Hysteroscopy involves viewing the internal organs like uterus and tubes using a camera aided tube.
Treatment depends on the extent of damage. Surgery can repair minor blockages but is not helpful for patients with severe blockages.
• Laparoscopic surgery – helpful for treating minor scars and obstructions, generally used as first treatment step for young healthy women trying to get pregnant.
• In Vitro Fertilization (IVF) – This is considered the best treatment option because it bypasses the step of migration of the egg through the fallopian tube. In IVF the mature eggs are collected directly from the ovaries and fertilized with the sperm in the laboratory. Later healthy developing embryos are transferred into the uterus. This treatment option benefits women with severe fallopian tube obstructions and greatly improves the chances of successful pregnancy.