The fallopian tube also known as the Uterine tube transports an egg from the ovary to the uterus. Unless there is a biological defect, ectopic pregnancy, or surgery that might have resulted in the loss of one tube, women have two uterine tubes. The Blocked Fallopian Tubes may cause temporary or permanent infertility in women.
The ampulla is a section of the tube where generally an egg is inseminated by a man’s sperm. The fertilized egg is then transferred to the uterus, where it develops until birth. Some women may experience an ectopic pregnancy, which jeopardizes their fallopian tubes as well as their lives. Ectopic pregnancies occur when a fertilized egg remains in the fallopian tube rather than going to the uterus for the further developmental process. Certain infections can also harm the uterine tube.
When a fallopian tube becomes obstructed, both the path for sperm to reach the eggs and the path for the fertilized egg to return to the uterus are blocked. Certain infections, scarring of tissue, and pelvic adhesion are all common causes of obstructed fallopian tubes. There isn’t any noticeable symptom until a woman tries to conceive but in vain.
Cause of Uterine Tube Blockage
Usually, tissue scaring caused by various factors can lead to blockage of the uterine tube.
- Abdominal surgery done in the past can lead to adhesion that leads to tube blockage. An ectopic pregnancy that had happened in the past can scar the tubes.
- STDs like gonorrhea and chlamydia can lead to pelvic inflammatory disease.
- The growth of fibroids may obstruct the fallopian tube, particularly where it connects to the uterus.
- Endometriosis leads to the build-up of endometrial tissue in and outside the fallopian tubes and other supporting organs that cause blockage.
Blocked Fallopian Tubes- Types of Blockages
Hydrosalpinx is a disorder in which the fallopian tubes become obstructed at their junction with the ovary. It is almost difficult to become pregnant if both tubes are closed in this manner.
An ultrasound, in addition to an HSG, may be performed to diagnose this issue. In a process known as neo-salpingostomy, laparoscopic surgery can be performed to construct a new aperture at the end of the tube.
The outcome of this surgery is determined by the degree of the dilatation, the scar tissue around it, and if the tube is generally normal. Even after surgery, many patients require IVF if they want to conceive.
However, most females with hydrosalpinx are unable to do IVF immediately. Because the fluid in the tube cannot flow out the far end, it returns to the uterus. This fluid is harmful to embryos and changes the uterine lining, making it less welcoming to the embryo.
Hence, surgery is required to remove the tubes before beginning IVF to make it a successful attempt.
Proximal Tubal Occlusion
The obstruction of the fallopian tubes where they link to the uterus is known as proximal tubal occlusion. This form of tubal illness is caused by mucus plugs, fibroids, endometriosis, scarring, or inflammation.
HSG is typically used to identify proximal occlusion. However, after additional study with laparoscopy, many women identified with proximal tubal blockage on HSG have normal tubes.
While the patient is sedated, blue dye is injected into the uterus at greater pressure than is possible during an HSG. If the tube still has a proximal blockage, a surgical technique called hysteroscopic cannulation can be used to try to heal it.
Salpingitis Isthmic Nodosa (SIN)
Salpingitis isthmic nodosa (SIN) is a type of proximal tubal illness that is difficult to treat and needs special attention. The origin of SIN is unknown. However, it is connected with endometriosis and may be related to previous inflammation in the tract.
HSG scans of SIN commonly reveal “broccoli” lesions, which are diverticula (tube out-pouching). SIN-affected tubes are generally thick and tough when examined under laparoscopy.
Women with SIN are more likely to have infertility and ectopic pregnancy (pregnancy in the fallopian tube). Individuals with SIN are frequently advised to undergo IVF.
Blocked Fallopian Tubes- Treatment
If the fallopian tubes are obstructed by minor amounts of scar tissue or fibroids, your doctor can remove the obstruction and unblock the tubes using laparoscopic surgery.
If your fallopian tubes are completely obstructed by scar tissue or adhesions, therapy to remove the obstructions may be impossible.
Repairing tubes that have been damaged by ectopic pregnancy or inflammation by surgery may be a possibility. If a blockage is created by a damaged portion of the fallopian tube, a surgeon can repair the defective portion and reattach the two healthy portions.
Fallopian Tube Recanalization (FTR)
During FTR, your doctor will not need to create any incisions. They will introduce a tiny plastic tube, or catheter, through your cervix into your uterus using a speculum, which is a tool used to keep your vagina open.
They will then inject a contrast liquid via the catheter and take an X-ray of your uterus and fallopian tubes to determine the location of the obstruction.
Finally, a second, smaller catheter will be inserted to remove the obstruction.
In general, this surgery is only performed on a small number of individuals who have particular forms of tubal obstruction. This procedure still has certain risks of developing ectopic pregnancy as well as infection or injury that is caused due to insertion of the catheter.
Salpingostomy, also as Neosalpingostomy, is a procedure in which your doctor makes an opening in your fallopian tube. A hydrosalpinx is a clogged and bloated tube that is generally filled with fluid.
Your doctor will open your fallopian tube and remove the obstruction while leaving the tube in situ throughout the procedure. They will allow the incision exposed so that it can heal naturally. This also has the risk of developing ectopic pregnancy as well as infection, scarring, and adhesions.
Unlike salpingostomy, which cures the blocked fallopian tube while leaving it undamaged, a salpingectomy removes it completely during the surgery process. To enhance your chances of IVF, your doctor may prescribe bilateral salpingectomy or the removal of both fallopian tubes.
Your doctor can conduct laparoscopic salpingectomy in a variety of methods. To remove it, one method is to use a pre-tied surgical loop and tighten the knot around the fallopian tube. Another option is to damage the fallopian tube’s blood arteries.
Your doctor may recommend a fimbrioplasty surgery if you have a blockage in the portion of your fallopian tube which is closest to the ovary. This technique unlocks the clogged tube and preserves tissue known as fimbriae, allowing your eggs to pass through.
Fimbrioplasty is typically carried out as part of a salpingostomy, but in addition to removing the obstruction in your tube, your doctor will reconstruct the fimbriae. It also comes with the risk of developing adhesions on other reproductive organs and chances of ectopic pregnancy.
Tubal Ligation Reversal Surgery
This surgery is used to reverse the process of blockage that was previously done to prevent pregnancy. Your doctor will put you under general anesthesia for the operation, which means you will not be conscious. They will make a tiny incision in your abdomen and remove any obstructed fallopian tubes. To join the tubes, they will apply absorbable stitches.
Even if you get the procedure, there is no assurance that you will become pregnant. Depending on your age and other health variables, your odds might range between 40% and 80%.
Because tubal ligation restoration is abdominal surgery, infection, hemorrhage, and organ injury are all possibilities. Anesthesia has its own set of hazards.
Women under the age of 35 with normal ovarian reserve tests and a spouse with a normal sperm count are the best candidates for tubal reversal surgery.
It is possible to become pregnant after therapy for blocked fallopian tubes. Your possibilities of becoming pregnant will be determined by the manner of therapy and the degree of the block.
When the obstruction is close to the uterus, the chances of a successful pregnancy increase. If the obstruction occurs near the ovary at the end of the fallopian tube, the success percentage is reduced.
The chances of becoming pregnant following surgery for blocked fallopian tubes compromised by infection or ectopic pregnancy are minimal. It is determined by how much of the tube must be removed and which portion is removed.
Before beginning therapy, consult with your doctor to determine your chances of a successful pregnancy.