Blocked Fallopian Tubes
Blocked Fallopian tubes cause about 20% of female infertility cases. The tubes are delicate, dynamic structures that link the ovaries to the womb, and they’re very vulnerable to infections and damage. Natural pregnancies rely on the Fallopian tubes to support and enable an embryo to reach the womb, and mucus or scar tissue can block the passage of sperm or an embryo on this vital journey.
Women need at least one patent (open and functional) tube for a natural pregnancy; if one tube is blocked, it doubles the time it should take a woman to get pregnant. If both tubes are blocked, she won’t conceive without help, and any tubal abnormalities increase the risk of ectopic pregnancies.
Seven causes of Tubal Blockage
1. Pelvic inflammatory disease (PID)
- Sexually transmitted infections by bacteria, viruses, fungi or parasites.
- A miscarriage or a termination.
- Endometritis (inflammation of the endometrial lining of the womb).
- Abdominal infections such as peritonitis or appendicitis.
- Salpingitis (inflammation of the Fallopian tubes).
PID is often symptom-free, or the symptoms are mild, involving slight lower abdominal pain and tenderness that’s worse with pressure and possibly with a low-grade fever. About two-thirds of the women who have evidence of PID after a laparoscopy had never thought they’d had an infection. PID infections gradually reduce fertility by making the tubes less functional:
- 12% are infertile after one infection.
- 23% are infertile after two infections.
- 53% are infertile after three infections.
2. Mucus obstructing the Fallopian tubes
Excess mucus is usually due to problems with the “peg” cells (uterus and fallopian tubes) that line the tubes. The peg cells release nutrient-rich fluids that nourish sperm or an embryo in the tubes. But if the secretions are too thick (or too much), they can accumulate and form a sticky plug that blocks the tube. Fluids PF women are particularly vulnerable to this.
Alternatively, tubes can get blocked if the “cilia” cells aren’t moving the fluid enough to keep the tube open. The cells have (they have hair-like structures that beat to transport fluids (or an embryo) to the womb. This situation tends to affect Balance PF women the most. However, the underlying reason for mucus blocking tubes is from the person’s dynamics rather than from an infection.
3. After surgery
Tubal ligation operations that sterilize the woman are the usual cause; however, any lower abdominal surgery can trigger adhesion’s that block Fallopian tubes.
4. After IUD use
The insertion of intrauterine devices (IUDs) such as the Merina coil into the womb can trigger inflammation which can spread from the womb to the delicate tissue of the tubes.
Connective tissue often forms endometriosis, and this can cause either clump the finger-like ends of the tubes together or create adhesions in the tubes. The most common site for endometriosis is the ends of the tubes and around the ovaries.
Torsion twisting (and blocking) of a Fallopian tube and large cysts that weigh an ovary down are the usual cause. The weight of the ovary pulls the tubes out of position and distorts their shape. Because IVF stimulation drugs increase the number of large follicles in ovaries, they significantly raise the risk of this happening.
A hydrosalpinx can form after infections, and they grossly distort a Fallopian tube. They dramatically reduce the possibility of embryos reaching the womb and reduce natural and IVF fertility. The presence of a hydrosalpinx usually results in the tube being tied off before IVF is started. This prevents the fluid in them from draining into the womb and stopping implantation.
Testing options include:
- Hysterosalpingogram (HSG) is an X-ray that uses a special radio-opaque liquid injected into the tubes.
- Hystero-Contrast Sonography (HyCoSy) is an ultrasound technique where an aqueous fluid is injected into the tubes, providing a contrast medium to show the structure.
- Laparoscopy uses a special liquid in a process called “chromotubation“.
- Blood samples that detect Chlamydia antibodies will show if the most common cause of PID is an issue.
5 Treatments for blocked Fallopian tubes
- Tuboplasty is Fallopian tubal surgery and was once the primary option to restore patency to tubes, but tubes are delicate structures, and the risk of creating adhesions is relatively high.
- IVF techniques are now the usual treatment for “blocked tube infertility”.
- Flushing Fallopian tubes with oil-based media is an alternative and viable therapy. Flushing only applies to tubes that are blocked rather than scarred, and more research is needed. ii Flushing is a side benefit to testing tubal patency with HyCoSy.
- “Tubal recanalization” is a relatively new technique (and won’t be available everywhere). It has excellent outcomes for women with normal or minimally diseased tubes obstructed by adhesions or narrowing. It’s also called ‘falloposcopy‘ and can be performed in outpatient clinics. The technique is similar to a hysteroscopy but enters the tubes, iii and studies show success rates of 67% per tube and pregnancy rates of 55%. iv
- Herbal medicine is available as part of some morefertile support packages. Research shows 50% or more success rates in removing tubal obstructions where the tubes aren’t significantly damaged. The herbs encourage fluid metabolism, hormone balance and cilia function to remove mucus from the tubes. A recent study reported success rates of 90% using a combination of herbs and acupuncture, compared to a 68% success with Western medication. v
- Stop smoking as the toxins in cigarette smoke reduce cilia activity.
- Follow the advice on diet and lifestyle recommended for your Fertility Profile.
- Avoid or reduce dairy products and high-fat food if tubal mucus is an issue.
- A trained herbalist can sometimes remove adhesions or mucous blocks with herbal formulas.
- Castor oil packing is a technique used by naturopaths (and others) that reduce adhesions and scar tissue and should be used with caution by trained practitioners.