Have you been trying for a baby for some time and still aren’t pregnant? Do you suspect you may have blocked fallopian tubes and are wondering what your options are? Then read our guide to blocked fallopian tubes and getting pregnant.
When you desperately want a baby but keep getting that negative result on your pregnancy test, it can be heartbreaking. Maybe your period is always on time even though you wish it weren’t.
Every woman is different when it comes to conception. It seems like some women only need to look at sperm and they’re pregnant, while others try for months or even years.
If you’re in the latter category, blocked fallopian tubes are a possibility. Let’s look at the symptoms, causes, how they are diagnosed and the possibility of pregnancy if you have this condition.
What Are Blocked Fallopian Tubes?
Fallopian tubes are narrow tubes on either side of your womb or uterus. They connect your uterus to your ovaries.
Every month when your ovaries release an egg, it passes down the fallopian tubes. If there is an obstruction, the egg cannot pass through to the uterus.
Likewise, sperm cannot swim up the tubes to fertilize an egg. It’s in the fallopian tubes that conception usually occurs. The fertilized egg then travels to the uterus, where it embeds itself and grows.
Partial or fully blocked tubes can lead to infertility. If the blockage is partial, there is an increased risk of an ectopic pregnancy, where the fertilized egg grows in the fallopian tube.
About 30 percent of women who are infertile will be diagnosed with blocked fallopian tubes or tubal blockage. Of these women, 19 percent will be trying for a first baby for over a year without success (primary infertility). Another 29 percent will have had one successful pregnancy but fail to become pregnant a second time (secondary infertility) (1).
Symptoms of Blocked Fallopian Tubes
In general, you might not have any indication that your fallopian tubes are blocked until you can’t get pregnant. Months of trying to get pregnant and not succeeding are disheartening and upsetting. It’ll leave you wondering if there’s something wrong.
The chances are you’ll share your concerns with your healthcare provider. If you’re under the age of 35 and have been trying for a baby for a year, then investigations will be carried out to see if there is a reason for your infertility. If you are over 35 years old, then this might be done after six months.
Checking your fallopian tubes will form part of these fertility tests. One kind of blockage called a “hydrosalpinx,” might give symptoms. This is a build-up of fluid in one or both fallopian tubes which makes them larger. The sperm and egg can’t pass through the fluid, and therefore conception cannot take place.
Symptoms include pain in the lower abdomen which might be worse around the time of your period. You may also have abnormal discharge from the vagina (2).
Other conditions, like endometriosis or pelvic inflammatory disease, can also mean painful periods. While these conditions can make matters worse, they don’t always cause blockages directly.
Causes of Blocked Fallopian Tubes
It’s usually scar tissue or pelvic adhesions which cause a blockage in the fallopian tubes. There are several reasons for this, including:
- Pelvic inflammatory disease: This causes inflammation in the lower genital tract, which then spreads upwards to the cervix, uterus, fallopian tubes, and ovaries. In 85 percent of cases, this disease is the result of sexually transmitted bacteria (3).
- Endometriosis: The endometrial tissue lining the inside of the uterus can sometimes grow outside the womb or in the fallopian tubes. When this happens, it can cause a blockage. Up to 60 percent of women who experience painful periods have endometriosis, and it accounts for up to 30 percent of the causes of infertility (4).
- Fibroids: These non-cancerous growths affect the muscular tissue of the uterus and can grow up to a size of 7 inches or more. If they are near to the fallopian tubes, they can block them and cause infertility (5).
- Sexually transmitted diseases: Some infections women contract during sexual contact can lead to scarring on the ovaries. These include gonorrhea, chlamydia, trich, and mycoplasma. The scarring is likely to be worse if these diseases are left untreated (6).
- Previous ectopic pregnancy: A pregnancy that has happened in the fallopian tube can leave scarring or damage to the fallopian tube involved (7).
- Abdominal surgery: Previous surgery in the pelvic area may leave scarring and adhesions, which can lead to blockage of the fallopian tubes, causing infertility (8).
Some of these causes cannot be prevented. Nevertheless, practicing safe sex and getting early treatment can help stop blocked fallopian tubes as a result of sexually transmitted infections.
One thing you can do to help detect problems is to have regular check-ups with your gynecologic provider. If you have any concerns about pain or discharge, your provider may recommend a pelvic exam to determine the cause.
How Are Blocked Tubes Diagnosed?
A “hysterosalpingogram,” or HSG is a special X-ray that can show if tubes are blocked. This procedure doesn’t take long, only about five minutes.
Your doctor will insert a small tube into your cervix and then slowly fill your uterus with a dye containing iodine. You can see this dye on an X-ray. The path it takes will highlight whether there is a blockage in the tubes.
If a tube is blocked, then the dye won’t be able to pass. If not, the dye will pass through the ovaries into the pelvis, and the body will absorb it (9).
The HSG is a basic test, carried out when fertility is in question. It’s worth noting that 15 percent of women might have a false negative test and about 17 percent a false positive result. For these reasons, doctors might repeat the test or recommend other tests (10).
The HSG may be painful for some women. I’ve heard women say it was completely painless and others complain that it is excruciating. Speak to your doctor to see if you should take over-the-counter pain medication before the procedure.
Editor's Note:Caitlin Goodwin, MSN, RN, CNM
These other tests include:
- Ultrasound: For the fallopian tubes to show up on an ultrasound scan, there has to be fluid present. Consequently, for this treatment, a saline solution will be introduced to the uterus via a tube. The passage of the saline is monitored to see if there is a blockage (11).
- Laparoscopy or hysteroscopy: This surgical procedure involves a small camera on the end of a thin tube being placed into your uterus or abdomen. Carried out under a general anesthetic, it can detect abnormalities such as endometriosis, fibroids or adhesions (12).
Treatments for Blocked Fallopian Tubes
Treatments can be carried out to try and open your fallopian tubes. However, these are not without risks and your doctor will discuss these with you. There’s a chance they could be unsuccessful, or the tubes can re-block.
Another option is to bypass your fallopian tubes entirely and attempt IVF treatment. We will cover IVF more in a moment but first, let’s look at the options for treatment for blocked tubes.
- Tubal cannulation: During this procedure, a catheter is placed into the uterus, guided by wire, and is placed into the fallopian tube to clear the blockage (13).
- Laparoscopic surgery: We have described a laparoscopy when being investigated for blocked tubes. If a blockage is found then often the cause can be removed using the camera and special surgical instruments. This will often be done at the same time as the exploratory laparoscopy, possibly negating the need for further surgery (14).
- Fimbrioplasty: Doctors might recommend this procedure if the blockage is close to your ovaries. It clears the blockage and rebuilds the fimbriae, the small finger-like projections that move your eggs once released (15).
How successful these treatments are can depend on several factors, including age, where the blockage is, how bad it is, and the reason behind it.
There’s also an increased risk of ectopic pregnancy following tubal surgery. For this reason, if you become pregnant, you should be monitored closely by your healthcare provider.
Laparoscopic treatment for endometriosis can result in about a 40 percent chance of natural conception (16).
If you have minimal scarring and the tubes are otherwise healthy, then the chances of pregnancy are good after they are opened. This is also the case if you have only one blocked tube (17).
There are occasions when surgery may not be a viable option. If you have a lot of scarring or many adhesions in your tubes, or you have hydrosalpinx, then surgery is not likely to be a success. You might be better off considering IVF.
Other considerations when thinking about surgery to unblock fallopian tubes include (18):
- Male infertility: When it comes to getting pregnant, it takes two to tango! If your partner has infertility issues as well, then IVF — possibly with donor sperm — could be an option.
- Maternal age: IVF could also be considered a more favorable option for women over the age of 35 years.
- Issues with ovulation: If your ovaries are not working effectively, again IVF might be a good option for you.
In Vitro Fertilization (IVF) for Pregnancy
There was a time when surgery was the only option if a woman had blocked tubes. It was then a question of praying that it worked. The invention of IVF now gives couples another option for conception and pregnancy.
This treatment starts with you taking medications to improve your fertility by stimulating your ovaries to produce eggs. The eggs are then removed from the ovaries by a doctor using an ultrasound and a long thin tube, inserted from your vagina.
They are introduced to sperm from your partner in a special container in a laboratory. If your partner has fertility issues, then donor sperm can be used.
The eggs and sperm are closely monitored and, if all is well, in about three to five days, some healthy embryos will result. One or more embryos are then placed directly into your uterus, using a thin tube inserted through your cervix.
Hopefully, one or more embryos will then attach to the lining of your uterus and you’ll become pregnant (19).
Before IVF, your doctor may recommend removing your fallopian tubes or draining them. It appears that hydrosalpinx can affect IVF negatively (20).
I Had My Tubes Tied, Can This Be Reversed?
Some women choose to have their fallopian tubes “tied” as a method of contraception. Sometimes, they regret this decision later in life. Maybe they lose a child, or have another relationship where they now want more children.
The good news is that this voluntary surgery, called tubal ligation, to block your fallopian tubes can sometimes be reversed (21).
When the reversal is done microsurgically, the success rate of pregnancy is between 40 and 70 percent (22). IVF is still an option if you chose this method of birth control earlier in your life.
The decision to have a tubal ligation reversal as opposed to IVF can be a difficult one. There are factors you need to consider. If you are young and plan on having more than one child, then reversal might be a good option. However, if you are over 35 years old, IVF could be a better choice.
The cost of either procedure can vary from state to state. IVF will generally be more expensive and this might factor into your decision. Be sure you explore your options and are guided by a professional in the field when deciding what to do.
Summing It All Up
The chances of becoming pregnant naturally when you have blocked fallopian tubes can vary, depending on the cause and severity of the blockage.
If you have just one blocked tube, and the other is healthy, then you could get pregnant without intervention. Surgical options are available for those with two blocked tubes, but this is not successful, or possible, in some cases. In vitro fertilization remains an option for many women.
It can be hard to accept that you might not be able to conceive, but adoption or fostering are alternatives to consider. Discuss all your options with your doctor and make sure you receive emotional support throughout the process if you need it.