Blocked Fallopian Tubes and Pregnancy


Blocked fallopian tubes are common among the many possible causes of infertility.

There are two ways to get pregnant even if you have blocked fallopian tubes:

  • your fallopian tubes can be repaired with advanced microsurgery
  • or you can bypass the fallopian tubes through in vitro fertilisation (IVF) treatment.

Why blocked fallopian tubes require treatment

Fallopian tubes are a vital part of achieving pregnancy in natural unassisted conception. 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 (patent). 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 3 to 5 days after ovulation.

If your fallopian tubes are damaged or blocked, the egg and the sperm are prevented from interacting, and the proper movement of embryos along the tube to the uterus is obstructed, preventing a pregnancy.

How are fallopian tubes damaged or blocked?

As thin as the lead of a pencil, the fallopian tubes are delicate structures and are easily blocked or damaged. Blocked or damaged tubes reduce the chances of the sperm reaching the egg, as well as the chances of the embryo developing properly and implanting in the uterus. This is called tubal infertility.

The main cause of tubal infertility 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). Blockages in the fallopian tubes can be caused by scarring from infection or previous abdominal or pelvic surgery – especially surgery to the fallopian tubes or ovaries. Limiting post-operative damage depends on the competence of the surgeon.

Another known cause of fallopian tube damage is the intra-uterine contraceptive device or “loop”, especially when there are multiple sexual partners. Other possible causes include endometriosis and sexually transmittable disease such as gonorrhoea resulting in infection of the fallopian tubes.

How do I know if my fallopian tubes are damaged or blocked?

Using a pelvic x-ray called a hysterosalpingogram (HSG), a qualified fertility specialist will be able to determine if your fallopian tubes are blocked or damaged – and to what extent. The procedure 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.

What treatments are available for blocked fallopian tubes?

Given how crucially important your fallopian tubes are in falling pregnant, and how very delicate and easily damaged they are, treatments for damaged or blocked fallopian tubes require the help of specialists.

If it has been established that your fallopian tubes are blocked or damaged, are two options for treatment to enable your pregnancy: tubal surgery and IVF treatment.

Medfem Fertility Clinic offers both advanced microsurgical treatments as well as in vitro fertilisation as therapy for tubal factor infertility.

Tubal Surgery to Repair Blocked Fallopian Tubes

It may be possible to repair a fallopian tube, depending on the position of the damage or blockage – and the severity of the damage.

Fortunately, there is an alternative to “open surgery”: minimally invasive surgery or laparoscopy. Medfem Fertility Clinic’s specialists are experts and leaders in minimally invasive surgery. It is one of the first institutions in South Africa to have developed a fully comprehensive operating theatre with all the necessary equipment to perform minimally invasive surgery. The specialists at Medfem Fertility Clinic have all undergone extensive training abroad and teach endoscopic surgery on an ongoing basis to visiting gynaecologists.

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 (you will be asleep), but in most cases you will go home the same day. After the incision is made (usually next to the navel), the laparoscope is inserted into the abdominal cavity. Either carbon dioxide or nitrous oxide gas is then passed into the cavity to separate the abdominal wall from the underlying organs. This makes examination of the internal organs easier. Anywhere between one and three more incisions are made to allow access to other surgical instruments, for example, a laser. Once a diagnosis is made or the problem is removed (or both), the instruments are taken out, the gas allowed to escape and the incisions sewn shut. The stitches may need to be removed at a later stage or will dissolve by themselves.

Most women experience bloating, abdominal discomfort and/or back and shoulder tip pain for 24-48 hours after surgery. This is normal and is related to the gas used to distend your abdomen during the surgery. This pain should not be severe and should gradually improve over a day or two. You may also feel abdominal bloating, nausea, abdominal cramps, or constipation.

Most patients can resume normal activities within a few days to one week. We recommend that you do not engage in any strenuous physical activity for about a week or so. Following a pelvic laparoscopy, we recommend you use sanitary towels instead of tampons to cope with any vaginal bleeding or discharge.

It is absolutely essential that only a competent qualified fertility specialist perform this advanced surgery.

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In Vitro Fertilisation (IVF) Treatment

If surgery is not feasible because of extensive damage to your Fallopian tubes, In Vitro-Fertilisation (IVF) is another option.

In vitro fertilisation treatment was originally developed for women with damaged or missing fallopian tubes almost 40 years ago, in 1983. Since then more than 5 million babies have been born worldwide as a result of IVF treatment, with success rates comparable – and even superior – to those of nature.

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 that are 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.

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Where to get the right treatment for blocked fallopian tubes

At Medfem Fertility Clinic, our highly qualified fertility specialists have over 100 years of collective experience and are nationally and internationally recognised as pioneers and innovators in the field of fertility treatment. They are supported by extensively experienced embryologists; trained, qualified theatre staff, nurse practitioners and clinical psychologists; as well as specialist pharmacists and friendly administration staff, ensuring you receive the best care possible.

Starting your blocked fallopian tube treatment is as simple as contacting us to book an initial consultation by clicking here or contacting us telephonically on +27 (11) 463 2244. We look forward to meeting you!

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