A pair of tiny ducts called fallopian tubes capture and conduct human eggs from a woman’s ovaries to her uterus. One fallopian tube connects each of the two ovaries to the womb. In human reproduction, semen often fertilizes the egg within the fallopian tube, as the egg approaches the uterus.
A number of conditions can block fallopian tubes, preventing eggs from entering these tubes or from passing through them to the uterus. The tubes must be free of adhesions or obstruction, and must maintain flexibility and mobility to serve their function.
Finding the Cause, to Determine the Solution
Normally, the only practical implication or result of a blocked fallopian tube—though it is a major one for many patients—is fertility that is decreased or absent. Only one unblocked fallopian tube is necessary to achieve pregnancy, yet blocked tubes are the cause of a significant percentage of infertility in women. In addition, if the tube is only partially blocked, sperm may be able to reach the egg, but the fertilized egg may not be able to complete its transit from the tube, causing ectopic pregnancy.
Conditions that cause abnormal growths that press or pull against the tube to block it, or that scar its inner lining, include:
- uterine fibroids;
- uterine polyps;
- and ruptured appendix, previous ectopic pregnancy or previous surgery involving the fallopian tubes or abdomen.
The tubal blockage itself rarely produces signs or symptoms, but specialists can identify it using a variety of radiologic or medical-scoping techniques involving x-rays, ultrasound, endoscopy or laparoscopy.
Pursing the Least Invasive Route to Fixing the Blockage
If a woman has one open tube but difficulty in achieving pregnancy, fertility drugs may enhance her chances. Open or laparoscopic surgery may also serve to remove the source of anatomic stress on a blocked fallopian tube and reopen it.
If the blockage is near the uterus, the gynecologic surgeon can often insert a tiny tube or cannula into the duct to reopen, in a nonsurgical procedure. In contrast, surgery for deeper or more extensive blockages may involve removing the blocked segment of tube and reconnecting its ends. Or, the specialist may seek to remove the source of fluid build-up in the tube (a condition called hydrosalpinx), sometimes creating a new opening to the uterus. Finally, surgery can also mean rebuilding the ability of the distal end of the tube to pickup the egg from the ovary.
Most Advanced Laparoscopy
Lourdes gynecologic surgeons use a robotic surgical system to improve the accuracy of fallopian tube surgery and to make it easier to undergo. With this technology, they can laparoscopically perform delicate steps—such as opening the end of the tube or suturing the tube—that in the past required an open surgical incision in the abdomen.
Success depends in part on how badly the tube is blocked and on the success of the healing and regrowth of tissue within the tube is after the surgery. This healing can sometimes take an extended period of time. Most resulting successful pregnancies occur within the two years approximately following the procedure. If the gynecologic team cannot adequately return the function of the tubes, in vitro fertilization may be the next option for the patient to consider.
Lourdes’ experienced gynecologic staff helps the patient to identify and weigh the correct treatment choices.