Blocked Fallopian Tubes: Causes & Complications

A quick look at blocked fallopian tubes, ectopic pregnancy & more

Fallopian tubes are the tubal structures that connect a woman’s ovaries to her uterus. Fully functional fallopian tubes are extremely important to a woman’s ability to become pregnant and are where sperm and eggs initially meet before an embryo later travels to attach to the uterus.

Blocked fallopian tubes are the cause of about 35 percent of female infertility cases. When one or both of the woman’s fallopian tubes are blocked, it is known as tubal factor infertility. Our Parryscope® technique is excellent at finding fallopian tube blockage and can pick up problems that other tests might miss.

Ectopic pregnancy refers to when a fertilized egg implants outside of the uterus rather than in it, oftentimes within one of the fallopian tubes. Sometimes referred to as tubal pregnancy, ectopic pregnancies are sometimes the result of blocked fallopian tubes.

Pelvic inflammatory disease (PID) is one of the leading causes of blocked fallopian tubes. PID is a serious infection that develops when certain sexually transmitted diseases (STDs) or other infections aren’t treated. This can cause irritation and scarring that blocks fallopian tubes or puts women at higher risk of other forms of infertility.

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The effects of blocked fallopian tubes on fertility

The fallopian tubes are vital to the proper function of the female reproductive system. Women have two fallopian tubes, one connecting each ovary on each side of the uterus.

Each month a mature egg is released from the ovary in a process known as ovulation. The egg travels into one of the fallopian tubes, where it joins the male sperm for fertilization. The resulting embryo then travels through the tube to the uterus to implant for pregnancy.

When one or both tubes are blocked, it can cause infertility by either preventing the egg from being fertilized or preventing the resulting embryo from traveling to the uterus. Blocked fallopian tubes can also result in complications like ectopic pregnancy.

Most women are unaware that they have blocked fallopian tubes until they have difficulty conceiving, largely due to the fact that there are very few symptoms or indicators that the fallopian tubes are blocked. One of the most common reasons for blocked fallopian tubes is previous chlamydia infection, and 85 percent of women who’ve had this infection don’t realize they’ve had it.

Ectopic pregnancy

Ectopic pregnancy is the most common complication of blocked fallopian tubes, and it’s estimated that just 2 percent of pregnancies are ectopic.

A viable pregnancy results when the embryo completes its journey to the uterus, attaches itself into the uterine lining, and continues to grow.

An ectopic pregnancy occurs when the embryo implants in the wrong location, and in most cases the embryo implants within the fallopian tubes. Ectopic pregnancies can be the result of blocked fallopian tubes or a number of other risk factors including:

• Existence of scar tissue within the fallopian tubes.
• Advanced maternal age (35 years or older).
• Previous ectopic pregnancies.
• Untreated STDs or pelvic inflammatory disease.
• Endometriosis.
• Smoking cigarettes.

Though exceptionally rare, having an IUD or tubal ligation and then becoming pregnant can result in an ectopic pregnancy.

Depending on the severity, treatment and condition of the fallopian tubes after an ectopic pregnancy, most women can achieve a healthy pregnancy in the future. It is important to note that women who have had an ectopic pregnancy do have an increased risk of having another ectopic pregnancy.

If women have internal scarring in their tubes and get an ectopic pregnancy after a long period of subfertility, the ectopic pregnancy is often in the better of their two tubes, damaging it. For this reason, if having a tube removed (salpingectomy) for ectopic pregnancy, it is important to ask the doctor performing the surgery how the rest of the pelvis and the other tube look.

In vitro fertilization (IVF) can be a great option for women whose fallopian tubes were removed or damaged due to an ectopic pregnancy. This is often needed more frequently in women who have had an ectopic pregnancy because the affected tube takes damage from the ectopic and the other tube may be damaged from conditions that led to the ectopic pregnancy.

Pelvic inflammatory disease

When left untreated, gonorrhea and chlamydia can cause pelvic inflammatory disease (PID) in women. Five percent of asymptomatic chlamydia infections can cause tubal damage, but this increases to 20 percent with symptomatic chlamydia infections, and is even higher with gonorrhea.

Other infections such as bacterial vaginosis can also cause pelvic inflammatory disease, but this is far less common. This inflammation can result in the scarring of the fallopian tubes, creating blockages and dramatically limiting a woman’s ability to become pregnant. Infection related tubal damage is often more severe than other sources because it damages the cilia, which are little hairs that push sperm and egg together.

This is why a tube can be open but not always functional. That’s because even if it is open, without the cilia, sperm and egg have a hard time finding each other. And if they do, the resulting embryo may not make it back to the uterus, and may result in an ectopic pregnancy. For this reason, there is no great “Roto-Rooter®” to open the tubes, as even opening them (such as through Novy cannulation) won’t fix damaged cilia.

PID risks can be reduced through regular examinations, sexually transmitted disease (STD) testing and use of barrier contraception when not in a relationship with a known STD-free partner. STDs can be hard to identify because many people don’t have symptoms — that’s why getting tested for STDs is so important. PID symptoms may include:

• Heavy or painful periods.
• Abdominal pain.
• Exhaustion or fatigue.
• Fever or chills.
• Vaginal discharge that has an odd odor.
• Pain during sex.

PID can increase a woman’s risk for ectopic pregnancy. Extended exposure to STDs like gonorrhea and chlamydia can also result in the development of chronic pain and infertility as the result of PID.

Related information: Learn more about STDs and getting pregnant

Endometriosis

Endometriosis is a disorder in which tissue similar to that which grows inside the uterus during a woman’s menstrual cycle grows outside of the uterus, often on or within other organs. It can be quite painful and is one of the top three causes of infertility in women. Endometriosis can be difficult to diagnose, partly due to the fact that its symptoms are similar to many other reproductive disorders. Endometriosis symptoms include:

• Pelvic pain.
• Painful intercourse.
• Painful urination.
• Painful bowel movements.
• Severe abdominal pain.
• Lower back pain.
• Heavy periods or spotting between periods.

Endometriosis can cause tubal-factor infertility in two ways: excess, misplaced tissue can block the fallopian tubes, and excess tissue or the surgical removal of that tissue can scar the fallopian tubes. Endometriosis can also cause damage to an ovary through inflammatory effects, as well as trauma to the ovary when trying to remove endometriomas, which occur when endometrial tissue gets trapped inside an ovary.

Other causes of blocked fallopian tubes

Pelvic inflammatory disease, endometriosis and complications from previous ectopic pregnancy are just a few factors that can place women at risk of tubal factor infertility. Other causes of blocked fallopian tubes include:

• Scarring from previous surgeries.
• Damage from ruptured appendix & repair.
• Tubal ligation.

Fallopian tube blockage can not only put a woman at increased risk of ectopic pregnancy, but can also be caused by an ectopic pregnancy. Reproductive technology can help women with tubal blockages or women who have had tubal ligation in the past to become pregnant.

Diagnosing blocked fallopian tubes with Parryscope

Blocked fallopian tubes can be difficult to identify and are often accompanied by one symptom: the inability to become pregnant. The Parryscope® approach is an alternative to traditional methods of diagnosing infertility and identifying fallopian tube blockages. Traditional testing ­– including physical examinations, biopsies and special imaging procedures – can be painful and do not always provide accurate results.

The Parryscope approach, Dr. Parry’s patented approach to fertility testing, can gently evaluate whether there are any blockages in the fallopian tubes, the health of the ovaries, the number of eggs remaining, and the condition of the uterus in one 15-minute office procedure.

Learn more: Parryscope Fertility Testing

Other methods for identifying fallopian tube blockages

Traditional methods for identifying whether the fallopian tubes are blocked include hysterosalpingogram (HSG), sonosalpingography and minimally invasive laparoscopy.

Hysterosalpingogram (HSG) testing uses dyes and x-ray imaging technology to examine the uterus and fallopian tubes to see whether fluid travels through the fallopian tubes. This particular procedure can cause cramping, discomfort, and vaginal spotting and bleeding for up to 72 hours. Many women describe it as one of the most painful procedures they’ve ever had, with some even saying it was worse than childbirth. However, some women have minimal to no discomfort with HSG.

Sonosalpingography is an approach that uses air infused saline and watches to see if it goes through the fallopian tubes through a 2-dimensional ultrasound. Though the technique has potential, many OB-GYNs and REIs (fertility specialists) don’t know how to perform it. Additionally, it can be just as painful as HSG, can often take a doctor 100-200 procedures to learn how to do it well, and can sometimes only give information about one fallopian tube.

Laparoscopy is a minimally invasive surgical procedure in which a small instrument outfitted with a camera (laparoscope) is inserted through a small incision on the belly to examine the organs. This procedure is often considered to be the most accurate test. However, it is a surgical procedure and is often seen as a last result because of incisions, anesthesia, high cost and a postoperative recovery period.

Next steps: Empower yourself with knowledge

Learn more about female fertility testing options & how they compare with Parryscope.