Blocked Fallopian Tube

What is the Fallopian Tube?

Just like ovaries, fallopian tubes are also present in pairs on either side of the uterus, forming a connection between them. These are slender, flexible tubes that receive the egg from the ovaries after ovulation, where sperm can meet and fertilise it. After the fertilisation, the tubes also guide the embryo towards the uterus for implantation. Simply explained:

Fallopian tubes are the reproductive structures that transport eggs from the ovaries to the uterus and sustain fertilisation.

Considering the importance these tubes hold in the initial phase of conception, you can understand that even a minor blockage in any part of the fallopian tubes can prevent pregnancy.

What are the Symptoms of a Blocked Fallopian Tube?

Blocked fallopian tubes are asymptomatic in most women. Meaning many women do not even feel that their tubes are blocked until they start having problems conceiving, that too, after a detailed pelvic evaluation. In some cases, when the symptoms are experienced, these are not limited to tubal issues only. Some of the most common of these symptoms may include:

• Pelvic or lower abdominal pain
   
• Irregular menstrual cycles
   
• Painful periods
   
• Pain during intercourse
   
• Difficulty conceiving
   
• Unusual vaginal discharge (in case of infection)
   
• History of ectopic pregnancy, a type of pregnancy where the implantation has occurred outside the uterus.

What are the Causes of a Blocked Fallopian Tube?

Fallopian tubes are very delicate structures, which makes them very sensitive to even minor inflammation, scarring, or fluid buildup. Consequently, these sensitivities of the fallopian tubes can arise due to several different underlying medical, biological, or even external causes. Some of these causes may include:

• Pelvic Inflammatory Disease (PID)
   
• Endometriosis, an outgrowth of endometrial tissue outside the uterus
   
• Scarring from the previous pelvic, abdominal, or C-section surgeries.
   
• Sexually transmitted infections (STIs), especially chlamydia and gonorrhea, can indirectly block fallopian tubes by giving rise to PIDs.
   
• Hydrosalpinx (fallopian tubes filled with fluid)
   
• Pelvic or uterine adhesions
   
• Tuberculosis of the pelvis (common in some regions)

What are the Risks and Complications of Blocked Fallopian Tubes?

Beyond just being a structural issue, blocked fallopian tubes can lead to many risks and long-term complications if not treated on time. In addition to impairing fertility, it also increases the chances of conceiving outside the uterus, leading to a risk to life for both mother and child. To highlight, blocked fallopian tubes can cause the following risks and complications:

• Difficulty conceiving or infertility even after one year of trying.
   
• Increased risk of ectopic pregnancy
   
• Chronic pelvic or lower abdominal pain
   
• Recurrent infections
   
• Implantation issues due to hydrosalpinx fluid

Considering the life-threatening complications blocked fallopian tubes possess, early diagnosis and treatment become a priority.

How is a Blocked Fallopian Tube Diagnosed?

Being an asymptomatic disorder, diagnosing a blocked fallopian tube is a challenge in itself. That is, its diagnosis requires a combination of imaging tests along with minimally invasive procedures. Overall, all these procedures are done to assess the tubal patency and identify the underlying causes of this deficiency.

As a blocked fallopian tube is a structural issue of the uterus, the first step of diagnosis begins with evaluation of the structure and openness of the tubes, followed by confirmatory tests, which include:

HSG (Hysterosalpingography):

• It is the most widely used and primary test for detecting tubal blockage.
   
• During an HSG, a contrast dye is directly injected into the uterus to obtain X-ray images and assess whether the dye passes through the fallopian tubes.
   
• If the dye fails to pass through them, then it may indicate a blockage.
   
• Note that HSG is also only helpful in identifying the location and type of blockage.

Laparoscopic Evaluation:

Laparoscopic evaluation is used as a confirmatory test for tubal blockages. It is basically a minimally invasive surgery that allows doctors to visualise fallopian tubes, ovaries, and other uterine features with the help of a laparoscope. The best part of this process is that it not only serves as a diagnostic tool but also as a treatment option for some cases, such as minor adhesions or blockages.

Ultrasound and MRI:

Although ultrasound and MRI are not very useful in detecting tubal blockage, they can still detect its underlying or associated conditions, such as hydrosalpinx, ovarian cysts, fibroids, or endometriosis. This is one of the most important aspects of diagnosing blocked tubes. The reason for this test is to provide an extensive list of possible options for developing a fertility treatment plan for women who have had tubal blockages.

Why Early Detection Matters:

If you're a woman trying to get pregnant, then issues with your fallopian tubes are a good example of structural problems. Therefore, as soon as a blockage is found, diagnosis becomes crucial for determining whether surgery or In Vitro Fertilisation (IVF) will work to help you have a child. Diagnosing a blockage allows for more successful treatment options than if diagnosis had not occurred until after the fact. Apart from this, it also helps prevent complications such as ectopic pregnancy and infertility.

How is a Blocked Fallopian Tube Treated?

Since the fallopian tube is a crucial part of the uterine structure and natural conception, the first step in treatment is to understand the type, severity, and location of the blockage. For the context, tubal blockage can be classified into two major types, which include:

• Unilateral blockage: As the name suggests, in this type, blockage remains only in one fallopian tube on either side. Interestingly, women suffering from this type of tubal blockage may still be able to conceive naturally if the other tube is healthy and functional.
   
• Bilateral blockage: When both the fallopian tubes are blocked, natural pregnancy and even normal ovulation become a challenge. In such cases, an advanced treatment approach, such as IVF or ICSI, is used.

Here are some common and advanced treatment options to treat blocked fallopian tubes:

Tubal Cannulation:

• This is a common treatment for women who have mild blockages in the fallopian tubes adjacent to the uterus.
   
• The process for this treatment involves inserting a small, flexible tube into the tube(s) to assist in opening any obstructions within the tube (s).
   
• Though this type of treatment has proven effective and is minimally invasive, it is limited to only mild blockages and cannot correct severe blockages.

Laparoscopic Surgery:

This is also an option that does not involve extensive surgery. It also helps remove adhesions and/or endometriosis, which are preventing the fallopian tubes from functioning properly. In most cases, if mechanical obstructions or pelvic adhesions are seen during an HSG test, then a laparoscopic surgical procedure is done to treat the condition. However, this process, again, can not be used to treat severely damaged fallopian tubes.

IVF (In Vitro Fertilisation):

When the tubal blockage is very severe, or surgeries have failed to achieve conception, IVF (In Vitro Fertilisation) remains the most effective treatment. IVF involves the fertilisation of an egg with sperm in a laboratory environment, bypassing the need for fallopian tubes entirely. The fertilised embryo is then transferred directly into the uterus.

Importance of Expert Evaluation:

Expert evaluation is not optional; it is a necessity to overcome blocked fallopian tubes. A detailed assessment by an expert faculty member determines which treatment is best for you, based on your needs, age, medical history, and the type of tube blockage. And this assessment needs experience.

When Should You See a Doctor for a Blocked Fallopian Tube?

As mentioned earlier, blocked fallopian tubes are mostly asymptomatic, which causes them to go unnoticed. This makes early consultation even more challenging. However, that does not mean you have to suffer and see your condition worsen. You can be well prepared with the subtle signs mentioned earlier, or seek medical help if experiencing or have experienced the following:

• Difficulty in conceiving for more than a year, or 6 months when the female is above 35.
   
• History of pelvic infections or STIs
   
• Severe or persistent pelvic pain
   
• Previous ectopic pregnancy
   
• Past pelvic or abdominal surgeries
   
• Suspected endometriosis