Tubal Factor in Female Infertility
Approximately one-third of the causes of female infertility are due to tubal factors, which are blockages in the reproductive tubes. The fallopian tubes
, located between the uterus and the ovaries, can become blocked or lose their function for various reasons.
In this situation:
- The fallopian tube cannot retrieve the egg.
- The sperm cannot reach the egg.
- Even if fertilization occurs, the embryo cannot be transferred to the uterus.
As a result, pregnancy may not occur, or an ectopic pregnancy may develop because the embryo fails to reach the uterus.
What causes blockages in the fallopian tubes?
The main causes of tubal blockage are untreated infections and adhesions after surgery.
The most common causes are:
- Sexually transmitted infections (chlamydia, gonorrhea, etc.)
- Infection after IUD (intrauterine device) insertion
- Postpartum or post-miscarriage infections
- Pelvic inflammations
- Abdominal and pelvic surgeries (especially appendicitis or cyst surgeries)
These conditions can cause adhesions both in the internal structure of the tubes and in the surrounding tissues.
What are the symptoms of blocked fallopian tubes?
Blockages in the fallopian tubes often cause no symptoms.
Women usually only notice when they are unable to conceive. Sometimes, the following symptoms may also occur:
- Severe pelvic pain during menstruation
- Pelvic pain outside of menstruation
- History of ectopic pregnancy
Regular gynecological checkups and hysterosalpingography are crucial for early diagnosis.
How are blocked fallopian tubes diagnosed?
Blockages in the tubes are detected through both clinical evaluation and radiological imaging.
Hysterosalpingography (HSG) – Uterine Film
This is the most commonly used diagnostic method.
A contrast agent is injected into the uterus, and the patency of the fallopian tubes is assessed under X-ray.
The procedure takes approximately 15-20 minutes , and a mild pain similar to menstrual cramps may be felt.
Patients can have the procedure done under light anesthesia if they wish .
If the hysterosalpingogram shows a blockage, the fallopian tubes can be directly visualized using laparoscopic surgery. Treatment may also be possible in the same procedure.
How are blocked fallopian tubes treated?
Treatment for blocked tubes varies depending on the location and severity of the blockage.
Microsurgery (Falling Tubal Opening Surgery)
In some cases, the fallopian tubes can be surgically opened.
However, the success rate depends on the level of damage to the tube and the patient’s age. In vitro fertilization (IVF) treatment is especially recommended for patients over 35 or those with low ovarian reserve .
Removal of the Tube in Case of Hydrosalpinx
If the fallopian tubes are swollen with fluid (hydrosalpinx), this reduces the success rate of IVF. Therefore, laparoscopic removal of the tubes is necessary before IVF treatment.
Can blocked fallopian tubes show up on ultrasound
No.
A standard ultrasound does not show blockages in the fallopian tubes. A hysterosalpingography (HSG) or laparoscopy is absolutely necessary to determine whether the tubes are open or closed. These methods clearly reveal the location and extent of the blockage.
Can blocked tubes open on their own?
If the blockage in the fallopian tubes is due to a mild infection, it may be possible to open them with medication.
However, if the damage is extensive or the internal structure of the tube is damaged, spontaneous opening is not possible.
In such cases, microsurgery or in-vitro fertilization (IVF) treatment is preferred.
Can blocked fallopian tubes cause pain?
Blocked fallopian tubes usually don’t cause pain.
However, some women may experience a feeling of fullness in the pelvic area or symptoms similar to menstrual cramps.
The most important sign of blocked fallopian tubes is the inability to conceive.
If only one fallopian tube is blocked, natural pregnancy may be possible as long as the other tube is open; however, the probability is quite low.
Conclusion: Tubal Blockages Can Be Treated with Early Diagnosis
Fallopian tube blockage is one of the most important causes of female infertility.
Early diagnosis and appropriate treatment can increase the chances of pregnancy.
Depending on the patient’s age, the extent of tube damage, and egg reserve, the most suitable method may be microsurgery or in-vitro fertilization (IVF).
FertiJin Women’s Health and IVF Center, located in Istanbul, offers high success rates with customized treatment plans for patients experiencing tubal factor infertility.