Blocked fallopian tubes, or tubal occlusion, are one possible cause of infertility. There are usually no symptoms, but certain risk factors can increase the risk of developing the condition.
The fallopian tubes are muscular tubes that are lined with delicate hair-like structures. These “hairs” work in both directions, helping an egg travel from the ovaries to the womb (uterus) and helping sperm travel up to meet the egg.
Each fallopian tube ends in fimbriae, which are finger-like structures. The fimbriae catch and guide an egg when the ovary releases it.
The fallopian tubes play an important role in conception because they are where most eggs are fertilized.
If any part of the fallopian tube is damaged, for example, by surgery or an infection, it can become blocked by scar tissue.
Blocked fallopian tubes do not often present symptoms other than difficulty conceiving. Doctors typically classify this as having tried to conceive for
A blocked fallopian tube may cause symptoms such as pain in the pelvis or belly. This pain might happen regularly, such as around the time of their period, or be constant.
Sometimes, a blockage in a fallopian tube can cause a fertilized egg to get stuck. This is known as an ectopic pregnancy.
An ectopic pregnancy may not always cause symptoms and is usually detected during a scan. However, some may experience signs of pregnancy, such as stomach pain on one side of the body or vaginal bleeding. A person with signs of an ectopic pregnancy should seek immediate medical attention.
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 uterus 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 the area around them. In most cases, these conditions or procedures create scar tissue that can block the tubes.
The female reproductive system is made up of the ovaries, uterus, and fallopian tubes.
If a medical problem has affected any of these three areas, it may make becoming pregnant more difficult.
Each of the two ovaries is located near a fallopian tube. The ovaries store eggs, and one ovary releases an egg each month, which enters the fallopian tube and travels down into the uterus.
Though only one egg is released each month, this happens randomly. For example, the right ovary might release an egg for 3 months in a row, and then the left ovary might release an egg the following month.
If one fallopian tube is blocked, it may still be possible for an egg to be fertilized. If both are blocked, this is less likely.
Blocked fallopian tubes can be difficult to identify. The tubes can open and close, so it is not always easy to tell if they are blocked or just closed.
There are three key tests doctors use to help diagnose blocked fallopian tubes:
- An X-ray test known as a hysterosalpingogram (HSG). A doctor injects a harmless dye into the uterus, which should flow into the fallopian tubes. The stain is visible on an X-ray. If the fluid does not flow into the fallopian tubes, the fallopian tubes may be blocked.
- An ultrasound test, known as a sonohysterogram. This is very similar to the HSG test but uses sound waves to build up a picture of the fallopian tubes.
- Keyhole surgery, known as a laparoscopy. A surgeon makes a small cut in the body and inserts a tiny camera to take pictures of the fallopian tubes from inside.
A laparoscopy is the most accurate test for blocked tubes. However, doctors may not recommend this test for early diagnosis because it is invasive and cannot treat the underlying issue.
A doctor may be able to suggest a possible diagnosis based on medical history. For example, an individual may have had a burst appendix in the past. If the person has had difficulty conceiving, this could suggest blocked fallopian tubes as a likely cause.
It may be possible to open blocked fallopian tubes surgically. However, this depends on the extent of the scarring and the location of the blockage. It’s important to consider the cilia, too, as just opening a damaged tube may increase the risk for an ectopic pregnancy.
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
Most surgeons will carry out the procedure using keyhole surgery.
Surgery aims to open the fallopian tubes to improve the chances of conceiving. Whether or not a person will be able to conceive after surgery is affected by:
- age
- the health of the sperm
- the level of fallopian tube damage
If surgery is unsuccessful, a doctor may recommend in vitro fertilization (IVF). IVF involves placing fertilized eggs directly into the uterus, which means that the fallopian tubes are not involved in pregnancy.
Surgery to open the fallopian tubes carries the same potential complications as any surgery. These include:
- infection
- creation of more scar tissue
- damage to organs
- bleeding
However, keyhole surgery is relatively low risk.
One risk of pregnancy after surgery is an ectopic pregnancy, meaning that a fertilized egg gets stuck outside of the uterus, often in a fallopian tube. The egg will not develop, and there can be a risk to the person’s health.
People who have tubal surgery should see a doctor as soon as they find they are pregnant to check for an ectopic pregnancy.
When planning a pregnancy, it can be a good idea to consider a person’s medical history. This can include risk factors for blocked fallopian tubes, such as prior surgery in this area or a relevant infection. These considerations may help to diagnose a possible cause of infertility.
The outlook for fertility is considered to be reasonably good if only one tube is affected or scarring is minimal. If surgery to treat blocked fallopian tubes is not successful, IVF might be an option.