It’s unusual for a woman with blocked fallopian tubes to experience any symptoms, and as a result, many women assume that if they are having regular periods, their fertility is fine. This isn’t always true.
Blocked fallopian tubes are a common cause of infertility. If you have been trying to get pregnant without success and you suspect your fallopian tubes are blocked or damaged, despair not because you can still get pregnant. IVF offers the best choice to achieve your desired goal.
If you want to overcome the challenge of blocked or damaged fallopian tubes and get pregnant, you do need to be proactive. This begins by understanding why and how your fallopian tubes are important to you getting pregnant
How blocked fertility tubes causes infertility is quite simple. Each month, during your ovulation, an egg is released from one of your ovaries (you have two of them). The egg travels from the ovary, through one of your tubes into the uterus. The sperm also need to swim their way from your cervix, through your uterus, and through the fallopian tubes to get to the egg. Fertilisation usually takes place while the egg is traveling through the tube. If one or both fallopian tubes are blocked, the egg cannot reach the uterus, and the sperm cannot reach the egg, preventing fertilisation and pregnancy.
In natural conception, the fallopian tubes are a vital part of achieving pregnancy. The finger-like projections at the end of the tube ‘collect’ the egg which is ovulated from the adjacent ovary. To do this, fallopian tubes must be freely movable, not stuck to the pelvic wall, uterus or ovaries by adhesions.
Once the egg is collected, the tube safeguards the egg until it is fertilised by sperm, where after it nurtures the resulting embryo as it moves through the length of the tube to the uterus over five days. To function as an incubator where the egg and sperm meet and the initial stages of embryo development takes place, the tubes must be open. In addition, the inside lining of the fallopian tubes must act as a conveyor system, moving the developing embryo to the uterus where it implants three to five days after ovulation.
If your fallopian tubes are damaged or blocked (tubal factor infertility), your egg and your spouse’s sperm are prevented from interacting, and the proper movement of the embryos produced along the tube to your uterus is obstructed, preventing you from getting pregnant.
Your fallopian tubes are delicate structures, they can easily become blocked or damaged, which is called tubal infertility and reduces the chances of the sperm reaching the egg, proper embryo development and implantation in the uterus.
Blockages may be due to scarring from infection or previous abdominal or pelvic surgery especially when your fallopian tubes or ovaries were involved.
The main cause of tubal infertility, however, is pelvic inflammatory disease (PID), which is also associated with an increased risk of subsequent ectopic pregnancy (when the fertilised egg implants in the fallopian tube instead of the uterus).
The use of the intra-uterine contraceptive device (IUD or contraceptive ‘loop’), especially when there is more than one sexual partner is also a common risk factor for tubal damage. Other possible causes include endometriosis and sexually transmittable disease such as gonorrhea resulting in infection.
Once you suspect or you have confirmed that you have a fallopian tube challenge, it makes sense to contact a specialist fertility clinic.
Given how crucially important your fallopian tubes are in falling pregnant, and how delicate and easily damaged they are, it is clear that falling pregnant with damaged or blocked fallopian tubes will require the help of specialists.
It is necessary to determine if – and to what extent – your fallopian tubes are damaged or blocked. Only a qualified fertility specialist will be able to determine if your fallopian tubes are blocked or damaged, using a pelvic x-ray called a hysterosalpingogram (HSG). The test involves the injection of dye into the uterine cavity and a simultaneous x-ray of the uterus and tubes, allowing the specialist to see any damage or blockage.
It may be that the flexibility of the fallopian tube is reduced, so it can’t pick up the egg when it is released from the ovary. There may be a total blockage preventing the sperm and egg to meet and produce an embryo. It could also be that there is damage to the inside wall of the fallopian tube, which prevents the embryo from moving down to the uterus. This could result in an ectopic pregnancy, where the embryo attaches to the side wall of the fallopian tube, resulting in rupturing of the tube at about seven weeks pregnancy duration.
The position and severity of the damage or blockage will determine which treatment is right for you. If it has been established that your Fallopian tubes are blocked or damaged, there are two options for treatment to enable your pregnancy: tubal surgery and IVF treatment.
Depending on the position of the damage or blockage – and the severity of the damage – it may be possible to repair a fallopian tube through minimally invasive surgery or laparoscopy.
Minimally invasive surgery or laparoscopy involves looking directly into your abdomen and pelvis using a small camera that is placed through an incision in your umbilicus. This allows a specialist to evaluate and potentially treat gynaecological problems such as scar tissue, adhesions and endometriosis.
For this operation you will require a general anaesthetic, but in most cases you will go home the same day and can resume normal activities within a few days to one week. It is absolutely essential that only a competent qualified fertility specialist perform this constructive surgery. It is also important to note that very few patients qualify for this kind of intervention.
If surgery is not feasible because of extensive damage to your Fallopian tubes, IVF is the best option. In the simplest terms, IVF treatment is a process of assisted reproduction where the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.
However, IVF treatment is not a single event, but rather a series of procedures completed over five stages to complete a treatment cycle.
IVF treatments commence with a course of hormone therapy to stimulate the development of several follicles in the ovary. Under ultrasound guidance, these are then punctured with a specialised needle to retrieve eggs, which are then fertilised in a petri dish (‘in vitro’ which literally means ‘in glass’) to create several embryos. After three to five days in an incubator, one or two of these embryos are transferred through the vagina to the uterus, where implantation occurs and pregnancy begins. The whole process from commencement of ovarian stimulation up to the embryo transfer stage usually takes just under three weeks.