Understanding Tubal Factor Infertility
There are many potential causes of female infertility. Blocked fallopian tubes, also referred to as tubal disease or tubal factor infertility, account for 25-30% of all cases. Below, we explain how fallopian tube obstruction may prevent natural conception and what treatment options can support your family building journey.
How do blocked fallopian tubes impact fertility and pregnancy?
Fallopian tubes are female reproductive organs that connect the ovaries and uterus. They transport an egg from an ovary to the uterus during ovulation, the phase of each menstrual cycle in which the ovaries release a mature egg.
Healthy, functioning fallopian tubes are involved in several key steps of the natural conception process. First, they are the passageway through which sperm reaches an egg for fertilization. The fertilized egg will then move through the fallopian tubes until it reaches the uterus for implantation.
There are varying degrees of fallopian tube obstruction. The condition may take the form of:
- Mild adhesions or scar tissue in either or both fallopian tubes
- One narrowed fallopian tube as the result of adhesions or scar tissue
- Two narrowed fallopian tubes as the result of adhesions or scar tissue
- One completely blocked fallopian tube as the result of adhesions or scar tissue
- Two completely blocked fallopian tubes as the result of adhesions or scar tissue
- Hydrosalpinx, a severe form of tubal disease in which a blocked fallopian tube becomes enlarged and filled with fluid
While any of the above structural issues can potentially interfere with the fertilization of an egg, it is possible to become pregnant naturally if the fallopian tubes are only partially blocked. However, conceiving naturally with a partial blockage may increase the risk of an ectopic pregnancy, which is when an embryo implants outside of the uterus. (90% of ectopic pregnancies occur in the fallopian tubes.)
Ectopic pregnancies can lead to very serious complications, such as ruptured fallopian tubes, without prompt treatment to end the pregnancy. Given this risk, anyone with a history of fallopian tube blockage should inform their doctor as soon as they think they might be pregnant.
A hydrosalpinx may prevent the possibility of pregnancy in some cases, as the fluid can be toxic to an embryo. This interferes with successful embryo implantation in the uterus, a critical step in the reproductive process. In other cases, a person with hydrosalpinx may be able to become pregnant, but the resulting inflammation of the uterine lining can still interfere with the typical development of an embryo in a healthy pregnancy.
What causes fallopian tube blockage?
Blocked fallopian tubes may develop as the result of the following health conditions and infections.
- Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows in the ovaries, fallopian tubes, or lining of the pelvic cavity. When it develops in the fallopian tubes, the resulting scar tissue may lead to fallopian tube blockage.
- Physical trauma to the female reproductive organs, like a previous abdominal surgery or ruptured appendix, can also contribute to the accumulation of scar tissue in the fallopian tubes.
- Pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, or ovaries, can lead to the accumulation of scar tissue and fluid in these organs. PID typically develops when bacteria enter the female reproductive tract. It is often a complication of untreated chlamydia or gonorrhea.
What are typical symptoms of blocked fallopian tubes?
Blocked fallopian tubes are rarely accompanied by noticeable symptoms other than difficulty becoming pregnant. Many women first learn that they have a fallopian tube blockage after consulting a doctor for a fertility evaluation. However, more extensive fallopian tube obstruction may be accompanied by chronic mild pelvic or abdominal pain. This is most common with a hydrosalpinx.
How is fallopian tube blockage diagnosed?
Blocked fallopian tubes are typically diagnosed with a hysterosalpingogram (HSG) or a laparoscopy.
- A hysterosalpingogram (HSG) is an x-ray taken to examine issues within the uterus and fallopian tubes. In this process, dye is injected into the uterine cavity through the vagina and cervix. If there is no fallopian tube blockage, the dye will flow through the fallopian tubes.
- A laparoscopy is a minimally invasive procedure that inserts a small camera through the abdomen to evaluate reproductive organs including the fallopian tubes.
What are the treatment options?
Surgery and in vitro fertilization (IVF) are the two main treatment options for people with tubal factor infertility. The best option for you depends on the extent of the blockage and individual reproductive health factors.
Surgery may be an appropriate treatment option for someone whose fallopian tubes are not severely damaged if there aren’t additional infertility factors. If you are conceiving as a couple, a partner’s sperm count and quality should be accounted for as well.
Tubal surgery can increase the risk of an ectopic pregnancy. If you have had this procedure, it’s even more critical to contact your doctor right away if you believe you may be pregnant.
IVF is a form of assisted reproductive technology (ART) in which an egg is fertilized with sperm outside of the body and then placed into the uterus with the potential outcome of a pregnancy. Since IVF bypasses the fallopian tubes, implanting a fertilized egg directly into the uterine lining, it is a common treatment for tubal factor infertility.
It is typically recommended for people with fallopian tube blockage who are less likely to have success conceiving naturally. This includes people with severely damaged fallopian tubes as well as those with less severe fallopian tube damage but other infertility risk factors.
Hydrosalpinx has been associated with lower IVF success rates. If you have this type of fallopian tube damage, your doctor may recommend fallopian tube removal before starting IVF.
The cost of treatment and insurance coverage are also important factors to consider as you explore your options.
Choose the right fertility pharmacy
Fertility treatment can be a challenging journey, but Alto is with you every step of the way. We offer reliable same-day delivery of your medications and fertility resources like personalized injection guide videos and access to fertility-trained pharmacists.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.