By Zaira Salvador BSc, MSc (embryologist) and Elena Martín Hidalgo MD (gynecologist).
Last Update: 10/30/2018

The Fallopian tubes, also called oviducts, are two structures of the female reproductive system that connect the ovaries to the womb. Their function is to transport the egg as well as the resulting embryo after fertilization.

Keeping this in mind, any blockage that prevents the tubes from carrying out their function properly may lead to tubal factor infertility.

Based on whether the blockage affects one or both tubes, we can distinguish between a unilateral or bilateral blockage, respectively.

Causes

Only in one-third of the women who visit a fertility clinic, the cause of infertility is a blockage in the Fallopian tubes. Considering this statistics, it is one of the main cause of female infertility.

In order for pregnancy to occur naturally, tubal patency is a sine qua non condition. Only with patent tubes, the sperm will be able to hit the egg and fertilize it.

What follows are the potential causes of blocked Fallopian tubes:

Salpingitis
It causes inflammation of the fallopian tubes. Normally, this condition is caused by microorganisms or a Sexually Transmitted Disease (STD), such as Chlamydia trachomatis, due to its dissemination to a nearby organ, or endometriosic lesions.
Endometriosis
Endometrial tissue grows outside the womb, causing endometrial adhesions that block the tubes and what’s more, hinder their movement.
Hydrosalpinx
Medical term for fluid in the tubes, particularly next to the fimbriae. This pathology is caused by an infection as well.
Surgery
Surgical procedures performed around the pelvic area may affect the structure of the Fallopian tubes. Tubal ligation is included in this group.

Symptoms & diagnosis

Women with their tubes blocked do not have any symptoms indicating that there exists an obstruction.

Moreover, routine ultrasound scans performed at the OB/GYN’s office are rarely able to detect a blockage in the tubes. So, in most cases, the blockage goes unnoticed for several years till it is finally detected using other diagnostic methods.

Also, when the blockage is caused by an acute infection that causes pus, the walls of the tubes may adhere to each other, causing pain, malaise, or fever.The good news is that this type of infections do not have symptoms in most cases.

The main symptom of a tubal blockage, especially if it is bilateral, is infertility.

In fact, according to Dr. Elena Martín Hidalgo, specialist in Obstetrics & Gynecology, hydrosalpinx are rarely accompanied by symptomatology. Moreover, they are typically detected after a fertility evaluation of couples experiencing trouble conceiving.

In most cases, Fallopian tube blockage is detected after a fertility evaluation, provided that any of the following tests is included:

Hysterosalpingography (HSG)

Hysterosalpingography or hysterosalpingogram (HSG) is a key diagnostic test for the assessment of tubal patency. Furthermore, it helps identifying some abnormalities of the uterus as well.

HSG involves using a contrast medium through the cervix with a catheter or cannula. This iodized contrast medium fills up the uterine cavity and the tubes. If some kind of blockage exists, the fluid will be unable to travel to the tubes and be expelled through the peritoneal cavity.

The passage of the contrast medium through the female reproductive tract is registered with a series of X-ray images.

To perform a hysterosalpingogram, anesthesia is not required. It should be performed on the days between menstruation and ovulation to make sure that the woman is not pregnant.

Potential complications and side effects of HSG include allergic reactions to iodized contrast dye, and pain in case there exists a blockage. However, the passage of the contrast medium could unblock the tubes and cause the woman to recover her fertility.

Hysterosalpingosonography (sono-HSG or HSSG)

A sono-HSG or HSSG is an improved version of HSG that does not use a iodized contrast medium or X-rays to examine the female reproductive tract.

Images are taken via transvaginal ultrasound. For this reason, a HSSG can be performed at the OB/GYN’s office, which means that patients are not required to visit a special subunit or wait for the results.

Based on the contrast medium used to replace the iodized contrast dye, we can distinguish two types of sono-HSG:

Hysterosalpingo-contrast-sonography (HyCoSy)
It uses a physiological saline solution or galactose solution is used as contrast medium.
Hysterosalpingo-foam sonography (HyFoSy)
Performed using ExEm-gel for creating stable foam. It presents an excellent tubal transit and reduces the discomfort for the patient.

These groundbreaking techniques reduce the risks associated with X-ray radiation and allergic reactions to the materials used.

The gel foam used for a HyFoSy is created thanks to the ExEm Foam Kit, an easy-to-use product to check tubal patency.

Treatment & pregnancy

Blocked Fallopian tubes can be treated differently depending on the cause. If it an infection, your doctor will prescribe you antibiotics.

Laparoscopic surgery may be required to unblock the tubes and fix the tubes. However, one should take into account that this option does not translate into being able to get pregnant immediately afterwards. In fact, it can increase the risk of ectopic pregnancy.

In cases of irreversible tubal obstruction, turning to Assisted Reproduction may be recommended, including:

Intrauterine Insemination (IUI)
Only in cases of unilateral blockage. During this procedure, it is required that the woman develops one or two ovarian follicles in the ovary connected to the healthy tube. Only if this is possible, IUI can be successful.
In Vitro Fertilization (IVF)
Actually, it is the most advisable option in cases of tubal blockage. After undergoing controlled ovarian stimulation, the mature oocytes are retrieved and fertilized in the lab.

In the worst-case scenario, removing the tubes may be required (salpingectomy). The good news is that IVF continues being an option even after this surgical procedure.

If you need to undergo IVF to become a mother, we recommend that you use "The Calculator". In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.

Also, the report will inform you about the promotions or special prices that the clinics selected offer so you can benefit from them as well.

FAQs from users

What are the Fallopian tubes and what do they do?

By Zaira Salvador BSc, MSc (embryologist).

The Fallopian tubes measure 12 cm long and are the female structures that line the uterine cavity and point to the ovaries. It is the place where the sperm meets the egg to fertilize it. They transport the resulting embryo to the uterus (womb) for implantation and subsequent development during pregnancy.

Learn more: How Does Natural Pregnancy Occur?

Can you unblock fallopian tubes naturally with herbs?

By Zaira Salvador BSc, MSc (embryologist).

No, the only method that can unblock the Fallopian tubes accurately is laparoscopic surgery. Home remedies can be used to relieve the symptoms associated, including pain related to inflammation.

Why would a woman have a closure of the fallopian tubes?

By Zaira Salvador BSc, MSc (embryologist).

As already explained, the causes of blocked Fallopian tubes are varied. For example, salpingitis (inflammation of the tubes) is a common cause. It may be caused by endometriosis or hydrosalpinx as well.

Can you still get pregnant with blocked fallopian tubes?

By Zaira Salvador BSc, MSc (embryologist).

No, if both tubes are blocked, pregnancy will be possible with IVF (In Vitro Fertilization) only. But, if just one tube is blocked (unilateral obstruction), a natural pregnancy is still possible as long as the woman has normal ovulation cycles, although the chances are reduced by 50%. Another option would be Intrauterine Insemination (IUI), monitoring the cycle in order to make sure the woman ovulates on the unblocked side.

Suggested for you

Hysterosalpingography (HSG) is the main diagnostic test used to find out whether the Fallopian tubes are patent or not. Get more info by clicking the following link: How Is a Hysterosalpingography (HSG) Performed?

If you want to learn more about tubal factor infertility, read: Tubal Factor Infertility – Causes & Treatment.

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References

Atri M, Tran CN, Bret PT, Aldis AE, Kintzen G. Accuracy of endovaginal sonography for the detection of fallopian tube blockage. J Ultrasound Med 1994;13:429–34.

Friberg B, Joergensen C. Tubal patency studied by ultrasonography. A pilot study. Acta Obst Gynecol Scand 1994;73:53–5.

Gocial G. Primary therapy for tubal disease: surgery versus IVF. Int J Fertil Menopausal Stud 1995;40:297–302.

Heikkinen H, Tekay A, Volpi E, Martikainen H, Jouppila P. Transvaginal salpingosonography for the assessment of tubal patency in infertile women: methodological and clinical experiences. Fertil Steril 1995;64: 293–8.

Lorente J, López A, Pomares E. Manejo del hidrosalpinx. H.U. Reina Sofía. Córdoba.

Martínez-Cañavate MJ, Quea G, González S. Factor tubárico: hidrosalpinx. En: Remohí, Bellver, Matorras, Ballesteros, Pellicer. Manual práctico de esterilidad y reproducción humana. 4ª edición. Madrid: Editorial Médica Panamericana S. A.; 2012. p. 119–125.

Mol BWJ, Swart P, Bossuyt PMM, van Beurden M, van der Veen F. Reproducibility of the interpretation of hysterosalpingography in the diagnosis of tubal pathology. Hum Reprod 1996;11:1204–8.

Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 1992; 183:795-800.

Reproducción Asistida ORG. Video: ¿Qué síntomas hacen sospechar del hidrosalpinx? (Which are the symptoms that may indicate the presence of a hydrosalpinx?), by Elena Martín Hidalgo, MD, Aug 2, 2016. [See original video in Spanish].

Volpi E, Piermatteo M, Zuccaro G, Baisi F, Sismondi P. The role of transvaginal sonosalpingography in the evaluation of tubal patency. Minvera Ginecol 1996;48:1–3.

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Authors and contributors

 Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia (UPV). Embryologist specializing in Assisted Procreation, with a Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI). More information
License: 3185-CV
 Elena Martín Hidalgo
Bachelor's Degree in Medicine & Surgery from the University of Salamanca. Specialty in Gynecology & Obstetrics with training at the Virgen de la Salud Hospital of Toledo. Specialist in Reproductive Medicine with over 20 years of experience. Contributor of the Spanish Fertility Society (SEF) as a teacher and trainer of students of Master's Degree in Human Reproduction. Medical Director of clinic Reprofiv. More information
License: 28454504653
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