FALLOPIAN TUBES

What are Blocked Fallopian Tubes?

The fallopian tubes are two thin tubes, one on each side of the uterus, which help lead the mature egg from the ovaries to the uterus. A woman has blocked fallopian tubes (tubal factor infertility) occurs when an obstruction prevents the egg from traveling down the tube. This can occur on one or both sides and is the cause of infertility of about 40 percent of infertile women.

Most woman with blocked fallopian tubes may not experience any symptoms.

How Do Blocked Fallopian Tubes Cause Infertility?

When ovulation occurs each month, an egg is released from one of the ovaries. The egg travels from the ovary, through the fallopian tubes to the uterus. During intercourse, the sperm swims their way from the cervix, through the uterus, and through the fallopian tubes to get to the egg. Fertilisation usually occurs as the egg is traveling through the tube.
If one or both fallopian tubes are blocked, the egg cannot be fertilised, therefore preventing pregnancy.

In the event of a partially blocked fallopian tube, the risk of a tubal pregnancy or ectopic pregnancy increases.

What Are the Symptoms of Blocked Fallopian Tubes?

Women with blocked fallopian tubes rarely experience any symptoms though a specific kind of blocked fallopian tube (hydrosalpinx) may cause lower abdominal pain and unusual vaginal discharge. However, not every woman will have these symptoms.

 

If you have fallopian tube blockages, kindly contact United Medical for assistance.

What Causes Blocked Fallopian Tubes?

Women with blocked fallopian tubes rarely experience any symptoms though a specific kind of blocked fallopian tube (hydrosalpinx) may cause lower abdominal pain and unusual vaginal discharge. However, not every woman will have these symptoms.

The most common cause of blocked fallopian tubes is pelvic inflammatory disease (PID), a sexually transmitted disease. A history of PID or pelvic infection may also increase the risk of blocked fallopian tubes.

Other potential causes of blocked fallopian tubes include:

  • Current or history of an STD infection (such as gonorrhea or chlamydia)
  • History of abdominal surgery
  • History of uterine infection caused by an abortion or miscarriage
  • History of a ruptured appendix
  • Prior surgery involving the fallopian tubes
  • Previous ectopic pregnancy
  • Endometriosis
How Are Blocked Tubes Diagnosed?

Blocked tubes are usually diagnosed via a specialised x-ray commonly known as hysterosalpingogram (HSG).

A dye is inserted through the cervix using a tiny tube. Once the dye has been given, our specialist will take x-rays of your pelvic area. In a healthy woman, the dye will go through the uterus, through the tubes, and spill out around the ovaries and into the pelvic cavity. Should the dye not pass the tubes, the woman may have a blocked fallopian tube.

However, 15 percent of women have a “false positive,” where the dye doesn’t get past the uterus and into the tube. Should this happens, your doctor may repeat the test or order a different test to confirm.

Other tests that can be ordered include ultrasound, hysteroscopy or exploratory laparoscopic surgery. Blood work may be included to check for the presence of chlamydia antibodies (which would imply previous or current infection).

Potential Treatments: Can You Get Pregnant With Blocked Fallopian Tubes?

Blocked tubes are usually diagnosed via a specialised x-ray commonly known as hysterosalpingogram (HSG).

If you have one open tube and are healthy, you might be able to get pregnant without much help. Our doctors may also prescribe fertility drugs to increase the chances of ovulating on the side with the open tube.

However, if both tubes are blocked you may require the following:

Laparoscopic Surgery for Blocked Fallopian Tubes
Laparoscopic surgery may open blocked tubes or remove scar tissue that is causing problems in some cases. However, the chances of success depends on how old you are (the younger, the better), the location and the severity of the blockage and the cause of blockage.

If just a few adhesions are between the tubes and ovaries, then your chances of getting pregnant are around 20 to 40 percent after surgery. However, the risk of ectopic pregnancy is higher after surgery to treat tubal blockage. Our doctor should closely monitor and advise you if you do get pregnant.

This surgery may not be a good option for you if you have thick, multiple adhesions and scarring between your tubes and ovaries, or if you have been diagnosed with hydrosalpinx.

Other reasons to forego the surgery include male infertility issues, additional fertility factors besides blocked fallopian tubes (like serious problems with ovulation) or advanced maternal age. In such cases, IVF treatment is your best bet.

IVF for Blocked Fallopian Tubes
IVF makes conception possible even with blocked fallopian tubes. IVF treatment involves taking fertility drugs to stimulate the ovaries. After which, an ultrasound-guided needle will be used to retrieve the eggs directly from the ovaries. In a lab, the eggs are put together with sperm from the male partner or a sperm donor for fertilisation. In the event that your eggs are fertilised, we will opt for one or two healthy embryos and transferred to the uterus.

IVF, therefore, completely avoids the fallopian tubes so blockages don’t matter.

However, research has found that an inflamed tube does significantly decrease the odds of IVF success. If you have a hydrosalpinx (fluid-filled tube), our specialist may recommend surgery to remove the tube. Thereafter, IVF can be tried upon recovery.

 

If you are intending for family planning, kindly contact United Medical for assistance.

What is hydrosalpinx?

Hydrosalpinx refers to a fallopian tube that’s blocked with a watery fluid. To break down the term, “hydro” means water and “salpinx” means fallopian tube.

This condition is typically caused by a previous pelvic or sexually transmitted infection, a condition like endometriosis, or previous surgery. Although some women don’t experience any symptoms, others may experience constant or frequent pain in the lower abdomen or unusual vaginal discharge.

In all cases, the condition can have an impact on your fertility.

Keep reading to learn more about this condition, the different treatments that are available, and ways you might successfully achieve pregnancy with our doctor’s help.

How does this affect your fertility?

To get pregnant, sperm must meet an egg. Around day 14 of a woman’s menstrual cycle, an egg is released from an ovary and begins its travels down to the uterus to the waiting sperm. If a tube or tubes are blocked, the egg can’t make the journey and pregnancy can’t occur.

What are the causes of Hydrosalpinx?

Hydrosalpinx commonly results from a long-untreated infection in the fallopian tubes. A number of situations may lead to fallopian tube infection, including:

The residual effects of a prior sexually transmitted disease such as chlamydia or gonorrhoea prior ruptured appendix.

Excessive tissue build-up due to Endometriosis

The inflammation and healing process resulting from such infection destroys the delicate finger-like fimbria, which extend from the end of the fallopian tube to the ovary. Fimbria are responsible for carrying the egg to waiting sperm and moving egg and sperm together for fertilization. When injured, fimbria become fused together, thus closing off the tubes. Fluid then collects in the fallopian tubes, making it impossible for them to function.

Hydrosalpinx diagnosis, procedure & treatment

There are several ways to diagnose a hydrosalpinx. Because fallopian tubes are very tiny, all of these methods use some form of X-ray or camera to clearly view the anatomy:

  • In this procedure, a narrow probe is inserted into the vagina. Ultrasound technology uses sonar or high frequency sound waves to produce a real-time image of the fallopian tubes. A normal fallopian tube is usually not visible on an ultrasound; a tube filled with fluid will appear larger and ‘sausage-shaped.’ Ultrasound is brief, non-invasive and painless, and is often used in the initial assessment of the ovaries, uterus and fallopian tubes.
  • Hysterosalpingogram (HSG). This is an X-ray exam, during which a small amount of dye is injected into the uterus and fallopian tubes. The X-ray is viewed on a screen as the exam is conducted. As the dye disperses through the uterus, any blockages will be easy to visualize. If the fallopian tubes are open, the fluid flows through the tubes and spills into surrounding abdominal area. In the event of a blockage such as a hydrosalpinx, dye is unable to exit the fallopian tubes, and tubes will appear distended (‘sausage shaped’). HSG is performed in the 2nd week of the menstrual cycle (i.e. after menstruation).
If my fertility doctor diagnoses hydrosalpinx, will having IVF allow me to have a normal pregnancy?

On first glance, it would seem logical that an IVF (in vitro fertilization) procedure would lead to a successful pregnancy, even with hydrosalpinx. After all, if you have IVF, or in vitro fertilization, you are artificially fertilizing the egg, so it shouldn’t matter that the fallopian tubes are blocked because the fertility specialist manually implants the fertilized egg (embryo) directly into the uterus. There’s only one problem with this: the hydrosalpinx fluid (HF) may look like plain old water, but it is toxic and can actually cause a greater-than-50% rate of infertility even with IVF.

In other words, just being in the vicinity of the HF may be toxic to the embryo, and it will often result in unsuccessful implantation in the uterus. Because the correlation exists, women with a hydrosalpinx who are trying to conceive should have the problem surgically corrected before they attempt pregnancy (with or without IVF).

Treatment of hydrosalpinx with minimally invasive surgery

At United Medical, our doctors may repair the hydrosalpinx by making an incision into it, thus reopening the sealed end (this is called salpingostomy); we may also use other procedures such as needle drainage.  our fertility specialists prefer to use laparoscopic salpingectomy – the complete removal of the tube – because it provides for permanent correction. Laparoscopic salpingectomy is performed under general anesthesia and the surgery typically takes less than an hour. Removing the hydrosalpinx often dramatically increases IVF success rates.

Planning Ahead
You may wish to prepare a list of questions to ask before seeing us so that you will not miss out anything important. Ask for the appointment on a day when you know you will not be having your period. Be sure to bring a list of all medications and supplements that you are taking.
Can I walk in for an appointment or service?

We want to make sure we cater enough time for your visit with our doctor. As such, we strongly advise that you make a prior appointment with our staff. Our specialist will then meet you on the allocated time for a detailed discussion. Please call or email us for an appointment.

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