Fallopian Tubes and Fertility

Key Takeaways

• Fallopian tube blockages are a common reason people struggle to conceive. 
• These blockages can happen due to various factors, including infections, surgery, or endometriosis.
• While a blocked fallopian tube can be a challenge, there are effective treatment options through surgery or IVF to help you achieve your dream of having a family.

The Fundamentals of Fallopian Tubes

Fallopian tubes play a critical role in the reproductive system, serving as tiny “conveyor belts” for eggs to travel from the ovaries to the uterus. Each month during ovulation, an egg is released from one of the ovaries. The fallopian tubes, which are about 10-12 cm long, are responsible for catching the egg. Tiny hair-like structures called cilia line the inside of the tubes and help move the egg towards the uterus.

Any issues with these tubes can significantly impact fertility. When the fallopian tubes are blocked or damaged, it can prevent the egg and sperm from meeting – leading to what is called tubal factor infertility. In some cases, damage to the cilia alone may still compromise the tubes' ability to move the egg efficiently, even when there is not a tubal blockage. Tubal factor infertility is common and accounts for approximately 25% to 35% of female infertility cases, according to the American Society for Reproductive Medicine.

Causes of Damaged or Blocked Fallopian Tubes

Fallopian tube damage or blockage can happen in numerous ways. Causes of a blockage can include:

• Infections:  Pelvic inflammatory disease (PID) caused by sexually transmitted infections like chlamydia or gonorrhea can damage the fallopian tubes, leading to scarring and blockages.
• Endometriosis: This condition, which affects 1 out of every 10 women of reproductive age, involves tissue similar to the uterine lining growing outside the uterus. This can lead to inflammation and scarring in the fallopian tubes.
• Surgery:  Sometimes, pelvic surgeries, especially those involving ovarian cysts or endometriosis, can cause scar tissue formation that blocks the fallopian tubes.
• Ectopic Pregnancy: This occurs when a fertilized egg implants outside the uterus, most often in a fallopian tube. The resulting growth can cause the tube to dilate or even to burst, leading to damage and potential blockage. Ectopic ruptures can be an extremely dangerous medical emergency, sometimes causing severe internal bleeding, and so urgent surgical intervention is usually needed. The American College of Obstetricians and Gynecologists has a helpful FAQ page dedicated to understanding ectopic pregnancy.

What Are My Treatment Options?

At Fertility Associates of Memphis, we understand how overwhelming it can feel when facing infertility. We're here to help you understand your options and find the best path forward: 

• Surgical Repair:  Through minimally invasive laparoscopic surgery, we can remove scar tissue or adhesions, potentially opening blocked fallopian tubes. But even after surgery, patients may have difficulty trying to conceive – plus there’s a higher chance of an ectopic pregnancy if conception occurs. The bottom line: Surgery can help improve the structure of the tubes, but it can’t fully restore the tiny “conveyor belt” muscles that move eggs through the reproductive system.
• Selective Tubal Cannulation: In this straightforward procedure, a thin tube (cannula) is gently inserted through the cervix, into the uterus, and along the fallopian tube to clear any blockages. It can be done in the office or a surgical setting and is sometimes recommended as a first-line treatment for patients with blocked fallopian tubes. However, just like surgical repairs, selective tubal cannulation can’t make the tubes function like new, and many patients still experience difficulty in achieving pregnancy.
• In Vitro Fertilization (IVF):  IVF changes the game. By bypassing the blockage, IVF allows eggs to be retrieved, fertilized in a lab, and then implanted directly into the uterus. This process can provide a clear path to pregnancy when natural conception is hindered. Even if a patient has had her tubes tied, IVF can still be a viable option for achieving pregnancy.When choosing between surgery and IVF, the American Society for Reproductive Medicine suggests considering factors like age, egg quality, past pregnancies, desired number of children, and any fallopian tube issues. A semen analysis is also important to guide the best treatment option.

Contact a Fertility Care Expert

If you’ve been trying to get pregnant for more than a year without success, it’s important to see a fertility specialist. Women ages 35 to 39 should seek professional guidance after six months of trying, and those 40 and older should consult a specialist right away.We believe in equipping you to make informed decisions about your fertility journey, and our team is here to provide compassionate support and guidance every step of the way.  Contact Fertility Associates of Memphis for a personalized consultation with one of our board certified reproductive medicine specialists, and let us help you achieve your dream of becoming a parent.

This article should not replace personalized medical advice and is intended only to provide general information. Please consult with our fertility specialists for individualized recommendations tailored to your unique situation.