The fallopian tubes are women’s most crucial part of the human reproductive system. The fallopian tubes are important if you want to conceive naturally, as they allow sperm to reach the egg and allow the egg released by one of the ovaries to get fertilized by a sperm.
The anatomy of the fallopian tube is a bit complex and interesting. Our fallopian tubes and ovaries aren’t stuck together, instead, a finger-like structure called fimbriae stems out from the fallopian tube to catch the egg cell when it’s released. The egg cell then travels down a tube called the ampulla. This is where fertilization can happen when the egg meets the sperm cell. The fertilized egg cell then continues to move to the uterus for implantation.
If the matured egg cell isn’t fertilized then, the egg cell dies off within 24 hours and hormonal changes cause the uterus lining to shed and a new cycle begins
So, during the menstrual cycle, the ovaries release an egg into the fallopian tubes, but did you know that it doesn’t happen on both sides every month? There are lots of follicles in both ovaries but typically only one egg becomes mature and is released per cycle.
Do you know, around 1000 eggs are lost per cycle and the best eggs are chosen first by the body? No wonder Age is a major deciding factor.
There are various reasons why fallopian tubes can become blocked, including dehydration and the development of scar tissue.
Fallopian Tubes can get blocked for a variety of reasons, including:
Pelvic inflammatory disease is an infection that can affect your womb, fallopian tubes or ovaries and can cause inflammation.
Sexually transmitted infections like gonorrhoea and chlamydia
Endometriosis is an often painful condition where tissue which is similar to the uterus lining outside the uterus in the ovaries, fallopian tubes or abdominal cavity.
Previous abdominal or uterine surgery
Hydro salpinx, a fluid buildup, along with dilation of the tube.
How blocked fallopian tubes cause a delay in infertility?
The body’s reaction to the tissue injury is the laying down of the fibre or collagen strands. These fibres create an internal scar called adhesions. These adhesions help isolate the adhesion tissue and the immune system can start a healing process. Our bodies don’t have a way to clear this adhesion once the process is complete. Even small adhesions can create obstacles in the transport of eggs & sperm. When the adhesions are formed within the opening of the fallopian tubes, they partially or completely close the passage.
Tubal blockage can occur in several locations. Sometimes, the ends of the tubes are obstructed, while the openings into the uterus are still open. In many cases, the tube is filled with fluid which is a state of hydrosalpinx. Surgery is not indicated to improve fertility outcomes in the era of IVF for patients with significant tubal disease, the except when the presence of hydrosalpinges.
Fluid in the tubes (hydrosalpinx) contains dead cells along with toxic products that are highly toxic to embryo development and implantation. Hydrosalpingeal fluid can leak back into the uterus, causing a mechanical barrier to implantation.
Pregnancy rates were significantly higher following IVF in patients who had the removal of hydrosalpinges as compared to leaving them intact.
Treatment of hydrosalpinx can be
1. Proximal ligation of the tubes to prevent fluid leakage back into the uterine cavity
2. Removal of the diseased tissue (salpingectomy).
Proximal ligation and salpingectomy can be done via laparoscopy, a minimally invasive surgery that allows patients to be discharged on the same day.
The silver lining is, you can still get pregnant even if you only have one fallopian tube. The recent finding quote, that having one open fallopian tube doesn’t usually affect your chances of getting pregnant. It’s because an egg can travel from one ovary to the fallopian tube on the other side
This simply means you don’t need to worry about chances of getting pregnant being halved, if you have a single fallopian tube, assuming everything is normal.
Everyone’s fertility journey is different and factors like age, and cycle regularity, obesity, other co-morbid conditions can affect the chances of conceiving.
How to know the status of fallopian tubes?
Fallopian Tubes do not usually display any symptoms. Females get to know about fallopian tubes when they try to get pregnant. In some cases, blocked fallopian tubes have pain on one side of the abdomen.
Can pregnancy still be achieved with blocked tubes?
This depends on the condition. For example, a woman with only the fallopian tube open can get an IUI. But for a woman with both fallopian closed tubes, probably IVF is the only option.
Can blocked fallopian tubes reopen?
More than 90 per cent of the time, we can reopen at least one blocked fallopian tube and restore normal functioning.
Fallopian tubes must be open, and free of scar tissues. If you have at least one fallopian tube in a healthy condition, then natural or IUI-assisted pregnancy is possible. On the other hand, if both tubes are having problems, getting pregnant is more difficult.
Can Fallopian Tube Blockages Be Removed?
Similar to laparoscopy, blockages within the Fallopian tubes can be temporarily fixed with a process called tubal cannulation, which is a widely employed method.
What is Tubal Cannulation?
Tubal cannulation uses surgical procedures like hysteroscopy and laparoscopy. A narrow tube with a camera and light is inserted into the womb through a small incision of the abdomen. A thin wire (cannula) is inserted through the Fallopian tube and an opening is created and blockages are cleared. The success of this procedure is checked with a dye if it can pass through the Fallopian tubes.
Can IVF be done in case of blocked tubes?
Definitely yes. IVF is an effective way for the eggs to arrive in the uterus, without fallopian tubes. So IVF is as successful as IVF without blocked tubes.
Blocked fallopian tubes can be a problem on the journey of motherhood. Nevertheless, At Pearl women’s Hospital and Yash IVF, we have successfully treated many patients with blocked fallopian tubes. Do call us for any assistance with blocked fallopian tubes.