Blocked Fallopian tubes cause about 20% of female infertility cases because the tubes are delicate and very vulnerable to infections and damage. Natural pregnancies rely on the Fallopian tubes to nourish sperm and an embryo, as well as transport the embryo to the womb a week later. Excess mucus or scar tissue can block the passage of sperm or embryos on this vital journey.
Women need at least one patent (open and functional) tube for a natural pregnancy, and if one tube is blocked, it doubles the expected time it takes a woman to get pregnant. If both tubes are blocked, she won’t conceive without the help of IVF, and any abnormalities in the tubes increase the risk of ectopic pregnancies.
Five treatments for tubal blockages
1. IVF techniques are the usual treatment for “blocked tube infertility” as they remove the issue of the embryo arriving in the womb. If the tubes are diseased (especially hydrosalpinx), they are usually closed off to prevent unhealthy fluids from flowing into the uterus and disrupting implantation or pregnancy
2. 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
3. “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 that are 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, i and studies show success rates of 67% per tube and pregnancy rates of 55% ii
4. Flushing Fallopian tubes with oil-based media is an alternative and viable therapy that’s often a side benefit to testing tubal patency with HyCoSy. Flushing only works with tubes that are blocked rather than scarred, and more research has been called for iii
5. 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, and a recent study reported success rates of 90% using a combination of herbs and acupuncture, compared to a 68% success with Western medication iv
Self-help for blocked tubes
- Stop smoking because the toxins in cigarette smoke reduce cilia activity and encourage fluids to build up
- Follow the advice on diet and lifestyle that’s recommended for your Fertility Profile
- Avoid or reduce dairy products and high-fat food if tubal mucus is an issue
- Castor oil packing is a technique used by naturopaths (and others) that reduce adhesions and scar tissue, and it should be used with caution by trained practitioners
Tests for tubal patency
There are four tests that can be used to assess tube health:
- Hysterosalpingogram (HSG) is an X-ray that uses a special radio-opaque liquid injected into the tubes to show their structure
- 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
- A laparoscopy technique that uses a special liquid in a process called “chromotubation” that reveals whether the tubes are open or not
- There are blood tests that detect Chlamydia antibodies to show if the most common cause of PID is an issue
Seven Causes of blocked Fallopian tubes
There are seven potential causes of tubal blockage, and treatment has to reflect how and why the tubes are obstructed.
1. Pelvic inflammatory disease (PID)
- 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, with slight lower abdominal pain that’s worse with pressure and maybe a low-grade fever. About two-thirds of the women with signs of PID had no idea they’d had an infection, but they reduce fertility by reducing tube functionality:
- 12% are infertile after one infection
- 23% are infertile after two infections
- 53% are infertile after three infections
2. Excess mucus
Excess mucus is usually caused by “peg” cell problems (uterus and fallopian tubes) as peg cells release nutrient-rich fluids that nourish sperm or an embryo in the tubes. The fluids are essential, but if they’re are too thick (or too much), they can form a sticky plug that blocks the tube, and Fluids PFP women are particularly vulnerable to this.
Tubes can also become blocked if the “cilia” cells don’t move the fluid through the tubes enough to keep the tube open. The cells 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.
Endometriosis usually consists of connective or vascular tissue, and one of the most common sites for the lesions is at the ends of the Fallopian tubes or around the ovary. The endometriosis lesions can cause the finger-like ends of the tubes to clump together or create adhesions in the tubes.
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 needs the tube to be tied off before IVF is started to prevent the fluid in them from draining into the womb and stopping implantation.
ii ‘Long-term reproductive outcome after hysteroscopic proximal tubal cannulation – an outcome analysis’ Jacqueline P.W. Chung et al. Australian and New Zealand Journal of Obstetrics and Gynaecology <a
iii ‘Tubal flushing for subfertility’ Johnson Neil et al. The Cochrane Collaboration Published Online: November 10, 2010 href=”http://onlinelibrary.wiley.com/doi/10.1111/ajo.2012.52.issue-5/issuetoc”>Volume 52, Issue 5, pages 470–475, October 2012.
iv Ding L, Wang PJ, Zhu SM, Liu GY & Cao CL. (2014). Clinical study on the treatment of fallopian tube obstructive infertility with acupuncture and Chinese medicine. Modern Journal of Integrated Traditional Chinese and Western Medicine. 23(17).
v ‘Reproductive Endocrinology, 4th Ed’. Yen SSC, Jaffe RB, Barbieri RL. W. B. Saunders Co, 1999. ISBN 0-7216-6897-6.