What You Need To Know About Blocked Fallopian Tubes

What are fallopian tubes?

A crucial part of the female reproductive system, fallopian tubes – also known as uterine tubes or oviducts, are tiny, incredibly delicate tubes that stretch from the uterus to the ovaries.

The primary role of the fallopian tubes is to transport eggs from the ovaries to the uterus.

Every month when an ovary releases an egg (ovulation), the egg is picked up by the adjacent fallopian tube, and gently moved down the tube where it meets the sperm. The egg, if fertilised by
the sperm, is then called an embryo, and is gently moved along the fallopian tube all the way down into the uterus.

In essence then, the fallopian tube is the pathway that allows the egg and the sperm to meet and for fertilisation to take place.

Why are the fallopian tubes so important?

Once you understand that the fallopian tubes allow the egg and the sperm to meet so fertilisation can take place, it is easy to realise just how important these tiny, delicate structures are. Fertilization normally happens in the fallopian tubes.

Essentially, without functional fallopian tubes, an egg and the sperm won’t be able to meet – and natural conception is not possible.

As such, procedures to block the fallopian tubes can be used as a form of permanent contraception, or sterilization.

In order for conception to take place, a fallopian tube needs to be open all along its length, it needs to be free to move around and the inside of the tube needs to have a normal structure.

Problems with fallopian tubes

People most commonly hear about blocked fallopian tubes, and while that is certainly one possible problem, there are a number of other possible medical problems with the fallopian tubes that could be preventing conception. Fallopian tubes may be blocked for a number of different reasons, they may be damaged or swollen, or there could be damage to the actual structure of the tube preventing it from moving around freely or from moving the egg or embryo successfully along the tube.

For natural conception, the entire length of a fallopian tube needs to be able to move freely, unobstructed and not stuck to anything. This includes the little finger-like projections called fimbriae at the very end of the fallopian tubes that “pick up” the egg at ovulation. As there is no direct connection between the ovaries and fallopian tubes, the egg is transported to the uterus in a peritoneal fluid produced by the fimbriae on the edge of the tube’s opening.

There are many reasons why the movement of the fallopian tube can be impaired. One reason is adhesions, a term used to describe scar tissue. If you have a lot of scar tissue, it can hold the fallopian tubes down and prevent their free movement.

Blocked tubes could be the result of sterilization – a process in which the tubes are blocked in a medical procedure to eliminate the possibility of falling pregnant. Healthy, open and functional fallopian tubes are so critical to conception, that tubes can be purposely blocked as a form of permanent contraception.

It is also possible for debris of some kind to get inside the tube and cause a blockage. Similarly, there could be some slough or some tissue that is blocking the tube and preventing access or movement of an egg or embryo from one end to the other. Another possible cause of a blocked fallopian tube is an embryo that got stuck in the tube instead of moving down to the uterus, called an ectopic.

In some cases, the fallopian tube may not be blocked, but simply swollen or damaged by infection. This is called hydrosalpinx – “hydro” meaning water and “salpinx” being another term for a fallopian tube – and refers to when a tube has been damaged, usually by infection, causing it to swell up at the end and resulting in a lot of fluid accumulating in the tube. Hydrosalpinx is typically caused by a condition like endometriosis, a previous pelvic or sexually transmitted infection, or previous surgery.

Patients often ask if they can’t just take an antibiotic to treat an infection of the fallopian tubes. However, although the antibiotic may treat the infection, the damage to the tiny, delicate little structures of the fallopian tubes caused by the infection cannot be undone.

Furthermore, the fallopian tubes are not bland pipes – on the inside of a healthy fallopian tube there are tiny little hair-like projections called cilia on the cells of the lining. These tubal cilia are essential to the movement of the egg through the tube into the uterus. The cilia gently move the little egg along to where it can meet the sperm and if fertilised, the cilia gently move the embryo along to the uterus, where it will hopefully implant and become a pregnancy.

These cilia can also become damaged or infected. If the cilia hairs are damaged, they do not generally regrow but might cause scar tissue inside of that tube. If the tubal cilia are damaged, the egg may not get ‘pushed along’ normally but may stay in the tube. If the embryo can’t move freely down the fallopian tubes, it can implant in the fallopian tubes, or elsewhere outside of the uterus. This is called an ectopic pregnancy and it can be very dangerous, with a risk of rupture and even death. It can sometimes be removed from the fallopian tube, but in other cases the fallopian tube has to be removed.

The common causes problems with fallopian tubes

Given how tiny and delicate the fallopian tubes are, there are many common causes of damage to the fallopian tubes.
The most common cause is sexually transmitted diseases (STDs) including sexually transmitted infections, such as chlamydia and gonorrhea. Many women are unaware of the infection – and the damage it causes – as half of women suffering such an infection do not have symptoms. Nevertheless, the infection does spread to the tubes and silently inflicts damage until treated with antibiotics.

Another common cause of damage to the fallopian tubes is endometriosis, a condition in which the inner lining of the uterus begins to grow outside of the uterus. This can cause not only a great deal of period pain, but also the kind of inflammation, irritation and scar tissue that can cause damage to the delicate tubes.

Other possible causes of damage to the fallopian tubes include an internal infection caused by, for example, a burst appendix, bowel problems, or peritonitis – inflammation of the peritoneum, which is a silk-like membrane that lines your inner abdominal wall and organs. Damage to the fallopian tubes can also be the result of surgery to remove fibroids or cysts, which can cause adhesions or scar tissue.

Treatment for blocked, damaged or swollen fallopian tubes

The first step in receiving the right treatment for blocked, damaged or swollen fallopian tubes is simply to contact us by clicking here…

At Cape Fertility, we value each individual patient and provide affordable quality fertility treatment as well as higher success rates at our purpose-built premises in the beautiful city of Cape Town.

We look forward to providing you with our signature individualised and personalised care!