The fallopian tubes are two thin tubes that arise out of the upper portion of the uterus and end in a large funnel shape above the ovaries. Once ovulation has occurred, the egg is transmitted along the tube, by special hair-like structures called cilia, toward the uterus. Fertilization with a sperm typically happens in the , though the pregnancy should not implant there. A blockage can occur in either or both tubes. This prevents the egg from coming into contact with sperm cells and is a common cause of infertility.
Causes of Blockage
According to the American Society for Reproductive Medicine, anything that causes inflammation or scarring of the tube can cause a blockage. This includes a current or previous infection, like Chlamydia or gonorrhea, a previous ectopic pregnancy (pregnancies in the tube) or prior abdominal or tubal surgeries.
Ordinarily, the tube is filled with fluid that is moved along and exits at the fimbrae, a horn shaped structure that sits directly above the ovary. Sometimes, the blockage can prevent that fluid from exiting and cause the tube to dilate. This is called a hydrosalpinx. Inflammation is a common problem at the site of a hydrosalpinx.
Symptoms and Diagnosis of a
Infertility is a common reason for a blockage to be diagnosed, as most women do not have any symptoms. However, some women may experience intermittent lower abdominal or pelvic pain.
A hysterosalpingogram is the diagnostic test most commonly used to look for a blockage. A physician will inject a radiographic dye into the uterus, where it should pass into the tube. An x-ray is then taken to look for the presence of dye within the tube. Occasionally, a large hydrosalpinx may be noted during a routine sonogram.
Getting Pregnant with One Blocked Tube
If one tube is blocked, you can pregnant without medical intervention. It may be more difficult or may take longer. Each month, the ovaries alternate which one will produce the dominant, or maturing egg follicle. If the ovary at the end of the blocked tube frequently ovulates, this can make getting pregnant difficult, as the sperm and egg are not able to fertilize. You may want to consider having your cycle monitored by a reproductive endocrinologist for a few months to see if this is happening.
More Advanced Treatment
If after several months of trying, you are still not pregnant or if both tubes are blocked, you may need in vitro fertilization, or IVF. Your ovaries will be stimulated to produce many egg follicles, the eggs of which will be removed surgically. Fertilization takes place in the laboratory, and then the embryos are transferred back into the uterus, bypassing the blockage.
Treating a Blocked Tube
Unless you are having severe pain or recurrent infections, there is no need to treat a blockage. If your symptoms are concerning, the doctor may consider removing your fallopian tube. There are surgical procedures to remove or open a blockage, but it is important to keep in mind that often the scar and adhesive tissue itself (which is what is blocking the tube) actually damages the tube. This can cause the inflammatory process to reoccur. A course of antibiotics can treat an infection if one should develop.
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