Blocked Fallopian Tubes: Symptoms, HSG, and Getting Pregnant

The fallopian tubes function as passages for mature eggs and sperm during fertilization. When there is an obstruction in the passage, it becomes a "blocked fallopian tube." This article will elucidate the connection between fallopian tube blockage symptoms and pregnancy. Additionally, it will guide you through fallopian tube blockage surgeries, treatment methods, and dietary precautions.
 

The Blocked Fallopian Tube: What Is It?

Blocked fallopian tubes, also known as fallopian tube obstruction, are used to describe obstructions that exist inside the fallopian tubes. Fallopian tubes with one or both sides can develop this condition. Additionally, proximal and distal types of blocked fallopian tubes can be distinguished. Infertility caused by the tubal factor affects 8% of people receiving infertility treatments nationwide, according to the Taiwan Ministry of Health and Welfare (2020).
 

What Causes Blocked Fallopian Tubes?

Fallopian tube blockage has many causes, but common ones include pelvic adhesions, tubal inflammations, and bacterial infections:

• Pelvic Adhesions: Pelvic adhesions can be brought on by endometriosis, pelvic inflammation, and a history of pelvic surgeries.
• Tubal Inflammation: Incomplete miscarriages, localized lesions like endometrial issues, can cause ascending infections leading to chronic inflammation of the fallopian tubes, subsequently resulting in blockage.
• Bacterial Infections: Bacterial infections, such as bacterial vaginosis, can spread to the uterus and both fallopian tubes if untreated. These infections have the potential to cause tissue inflammation, which can result in an inflammation inside the fallopian tubes and the development of abscesses.

 

Symptoms of Blocked Fallopian Tubes

Most blocked fallopian tubes do not cause symptoms. Often, the condition is only discovered through medical exams after years of infertile attempts at conception. Nevertheless, some physical issues can act as red flags. It is advised to seek prompt medical attention if you experience any of the following symptoms:

• Increased vaginal discharge
• Abnormal vaginal bleeding
• Irregular or heavy menstrual pain
• Discomfort during urination
• Pelvic pain
• Pain after intercourse
• Rectal protrusion sensation
• Infertility

Getting Pregnant with Blocked Fallopian Tubes

Female infertility is typically caused by blocked fallopian tubes, which prevent sperm and eggs from fertilizing. However, if the fallopian tubes are partially blocked, there is a chance that fertilized eggs could implant and cause an ectopic pregnancy, which, if severe, could be life-threatening. Distal blockage can also result in hydrosalpinx, which affects embryo implantation by causing accumulated fluid to flow toward the uterus.
 

Unilateral Fallopian Tube Blockage

Although less likely, there is still a chance for a natural pregnancy. If aiming for natural pregnancy, it is recommended to undergo detailed examinations and then assess the option of surgical treatment to enhance the chances of conception.
 

Bilateral Fallopian Tube Blockage

Natural pregnancy is not feasible. If desiring natural conception, a thorough exam is advised to determine whether you need surgery. The risk of recurrent blocked tubes still exists, which reduces the likelihood of conception and raises the possibility of an ectopic pregnancy. Patients are typically advised to directly consider in vitro fertilization (IVF).
  Whether facing unilateral or bilateral fallopian tube blockage, the probability of natural conception significantly decreases. Thus, the success rate is notably higher by employing assisted reproductive techniques to retrieve eggs and directly implant embryos into the uterus.
 

Hysterosalpingogram (HSG): Examination of the Fallopian Tubes

Hysterosalpingography (HSG) is a procedure to view the outline of the uterus and fallopian tubes. During this procedure, a specialized contrast material is injected into the cervix and allowed to flow into the fallopian tubes. After that, images are taken using X-ray imaging, and the entire procedure takes about 30 minutes. This diagnostic procedure can identify conditions such as uterine abnormalities, fallopian tube distortions, as well as the location and severity of blockages. While undergoing HSG, some patients might experience mild discomfort in the abdominal area, and there could be allergic reactions to the contrast material in certain cases. Patients with a history of allergies should inform the doctor beforehand.
 

Timing of Hysterosalpingogram (HSG)

The recommended timing for fallopian tube radiography is around the 8th to 10th day of the patient's menstrual cycle (approximately the 3rd to 5th day after menstruation has ended). This is advised because it will result in clearer imaging because the uterine lining is thinner at this time.
 

Getting Pregnant After HSG

The concept of the "golden three months" for fallopian tube radiography refers to the period after contrast material is injected into the fallopian tubes, when the contrast material may temporarily clear minor blockages. Therefore, three months after having HSG, the pregnancy rate for patients with mild fallopian tube blockages can be increased. Medical studies show that the natural pregnancy rate during fallopian tube radiography when using a water-based contrast material is about 29%, while when using an oil-based contrast material, it rises to 38-39%.
   

Dietary Precautions Before and After HSG:

• Before HSG, avoid overly oily and spicy foods, and do not overeat to prevent nausea.
• After HSG, normal eating is permissible; drinking plenty of water will help flush out the contrast material.
• After HSG, it's beneficial to consume fresh fruits, vegetables, and dairy products.

 

Fallopian Tube Blockage Treatment

Depending on the type of blockage, different fallopian tube blockage treatments are available.
  For patients with bilateral fallopian tube blockage who have plans for fertility, we recommend undergoing in vitro fertilization (IVF) treatment. In order to avoid the blocked fallopian tubes, this method involves retrieving eggs and fertilizing them with sperm outside of the body. Patients with distal tubal blockage can receive antibiotic treatment to prevent the effects of fallopian tube blockage on embryo implantation. The swollen portion of the fallopian tube may need to be removed (partial salpingectomy) in patients with proximal tubal blockage.
 

Is Fallopian Tube Blockage Surgery Necessary?

Before the widespread adoption of reproductive medicine, surgical procedures such as fallopian tube reconstruction or reimplantation were performed for patients with fallopian tube blockage. However, the current practice is to advise direct entry into IVF treatment due to the high recurrence rate and low natural pregnancy rate linked to fallopian tube blockage surgery.
 

How to Prevent Fallopian Tube Blockage?

What dietary and lifestyle choices should you make an effort to avoid in order to prevent fallopian tube blockage? The best method of prevention is to avoid infections because infections are the main cause of fallopian tube blockage. Therefore, it is essential to keep your reproductive organs clean on a daily basis. Additionally, to lower the risk of fallopian tube blockage, it's important to avoid frequent induced abortions.
  Key Methods for Preventing Fallopian Tube Blockage:

• Maintain cleanliness and hygiene of the reproductive organs
• Maintain monogamous relationships and use condoms
• Avoid sexual activity during menstruation
• Refrain from improper induced abortions
• Maintain a healthy lifestyle with a balanced diet and regular sleep patterns

 

Success Story: Successful Pregnancy of Fallopian Tube Blockage

▲ IVF Patient with bilateral tubal obstruction got twins