Fallopian Tubes, Sub-fertility and Solution

A blocked fallopian tube is one of the seven most common causes of subfertility (Read the 7 most common reasons here).

15% of couples going through sub-fertility is due to tubal factors.

Essentially ‘eggs’ are picked up by the fallopian tube and fertilization process, i.e., the forming of the embryo when an egg and sperm meet, occurs in the distal end of the fallopian tube. So, when the fallopian tube is blocked there is interference to this fertilisation process.

There are a few reasons for a blocked fallopian tube, for instance,

• Previously caused infection such as sexually transmitted infection that leads to scarring of tubes and damages other reproductive organs.
• Genital tuberculosis is common and is an important cause of tubal disease in India.
• Infections following miscarriages and delivery are also another important cause of secondary subfertility.
• Sometimes women choose to have their tubes tied as a form of permanent birth control and sometimes situations change unexpectedly and many women seek tubal reversal surgery.

There are tests to detect fallopian tube blockage such as:

• They are usually assessed by an X-ray test, known as a hysterosalpingogram or HSG. A doctor injects a harmless dye into the womb, which should flow into the fallopian tubes. The stain is visible on an X-ray. If the fluid does not flow into the fallopian tubes, they may have a blockage.
• Keyhole surgery, known as a laparoscopy. A surgeon makes a small cut in the body and inserts a tiny camera to take pictures of the fallopian tubes from inside. The 1 cm long cut is made, below the navel and a blue dye is passed through the cervix and is observed by the doctor looking through the laparoscope to see if it flows through the tubes into the pelvic cavity, implying that the tubes are open. The whole pelvic and abdominal organs can be inspected using this procedure.

Once the tests have proved the existence of tubal block, the question is can they be removed or are there any treatments available?

Tubal blocks caused by infection are frequently seen in multiple segments and causes scarring and immobilisation of tubes. Hence only in the mild cases of tubal damage, surgery can be helpful. In others where the tubal disease is moderate to severe, IVF is the way forward.

In women who have undergone sterilisation operation in the past, reversal of sterilisation operation can be done to have further children with relatively good success.

For blockage due to Genital tuberculosis, the initial treatment includes anti-tuberculous drugs for 6 months which is usually sufficient to clear the infection and the conception rates improve post-treatment.

As fallopian tubes play an essential role in gamete transport, fertilization, and the early development of the embryo, blocked fallopian tubes can be easily bypassed with IVF.

IVF or In Vitro Fertilisation offers good chances of conception, as in this procedure, eggs can be picked up from the ovaries, fertilised outside and then implanted in the womb.

We hope this information is helpful. For a more detailed discussion, email us or simply make an appointment.