While there are many causes of infertility, a blockage of the fallopian tubes is often the reason why many women are unable to conceive. The fallopian tubes are the pathways in which the ova travel from the ovaries down into the uterus, and if there is a blockage in these tubes it can prevent this from occurring.
The fallopian tubes can sometimes become blocked or even damaged due to certain conditions that a woman may suffer from. In rare cases, the blockage to the fallopian tubes may have been present since birth as a birth defect, but has gone undetected until the woman reached adulthood and tried to conceive.
Get to Know Your Fallopian Tubes
Upon ovulation, the egg will travel from the ovary to the fallopian tubes where the sperm will meet the egg and fertilization occurs. Once fertilized the zygote (fertilized egg) is pushed through the fallopian tubes and into the uterus where implantation will occur.
The fallopian tubes connect to the uterus at the utero-tubal junction where the fallopian tubes open into the uterine cavity. These very thin tubules are lined with cilia, which are fine hair-like cells. From there they extend out and slightly around toward the ovaries on both side of female body.
The fallopian tubes are described in sections for medical reference. The infundibulum is the end near the ovary that is associated with the fimbriae. The fimbriae is a fringe of tissue at the distal end (opening side toward the ovary) of the fallopian tubes. The fimbriae are covered in cilia, which look like tiny hairs. Just prior to ovulation sex hormones signal the fimbriae to fill with blood and move to touch the ovary in a gentle sweeping motion. When an oocyte (ova) is released at ovulation, the fimbria and cilia sweep the oocyte into the fallopian tube to be moved toward the uterus to wait for fertilization.
The ampullary is the section of lateral tube (central section moving toward the uterus). The ampullary is the main part of the fallopian tube. From there, moving inward toward the uterus the tube narrows into what is known as the isthmus. The isthmus is the part connected to the uterus at the utero-tubal junction.
Cells of the Fallopian Tubes are Affected by Hormones
There are two types of cells within the fallopian tubes. Ciliated cells are most abundant in the infundibulum and ampullary. Estrogen increases the production of cilia cells in the fallopian tubes. Scattered between the ciliated cells are peg cells which produce tubular fluid. This fluid contains important nutrients for both sperm, oocytes (ova), and zygotes (fertilized ova). The secretions also promote capacitation of the sperm. You may not know it, but the sperm cannot mature for complete fertilization without this important fluid. Progesterone increases the number of peg cells. Estrogen increases the height and secretory activity of the peg cells. In addition, tubal fluid flows against the action of the cilia, near the fimbriated end. Not only is progesterone and estrogen balance vital to the menstrual cycle overall, but it is vital to the health and proper function of the fallopian tubes as well.
Causes of Blocked Fallopian Tubes
Location and Types of Blockages
These are the three main locations for fallopian tube blockages.
1. Proximal 2. Midsegment 3. Distal
There are different types of fallopian tube blockages. Because the fallopian tubes have different parts and are a tube, there may be different parts of the tube blocked. Each section has its own name. Doctors have also come to find out that there are patterns of disease or trauma that may affect certain parts of the fallopian tubes more than others.
Proximal tubal occlusion involves the isthmus. This can occur after infection such as complications from abortion, missed miscarriage, cesarean section or PID. Permanent birth control procedures like Essure block the isthmus.
Midsegment tubal obstruction of the ampullary is most often due to tubal ligation damage. Tubal ligation is a surgical procedure to permanently prevent pregnancy. Some women who have had tubal ligation change their mind later and life and choose to have this procedure reversed. This can be done surgically and has a 75% pregnancy success rate. Tubal ligation removal comes with its own risk for development of more scar tissue on top of scar tissue already present from the initial tubal ligation procedure.
Distal tubal occlusion is the type of blockage that affects the part of the fallopian tube end towards the ovary. This type of blockage is typically associated with hydrosalpinx. Hydrosalpinx is often caused by Chlamydia trachomatis infection, which is a sexually transmitted disease. Untreated Chlamydia is known to cause both pelvic and fallopian tube adhesions.
In less severe cases only the fimbriae may be damaged. They may become stuck together in masses or may be damaged enough to no longer function as they should. As we learned above, the fimbriae have the important role of sweeping the oocyte (ova) into the fallopian tube for fertilization. If they no longer function then the oocyte never makes it to its destination for fertilization.
Damage to any part of the fallopian tubes can also be caused by ectopic pregnancy, PID, endometriosis, uterine fibroids or abdominal surgery.
Common conditions that may cause blocked fallopian tubes are:
- Pelvic Inflammatory Disease (PID)
- Uterine Fibroids
- Ectopic pregnancy
- Tubal Ligation Removal
- Complications from lower abdominal surgery such as Cesarean section
- Genital Tuberculosis (still common in developing countries, especially India)
Endometriosis and Fibroid tumors are both conditions which are becoming present in more women every year. In fact, an astounding 13.6 million women in the United States alone suffer from mild to severe endometriosis.
Pelvic inflammatory disease is another common condition which women suffer from. Pelvic inflammatory disease or PID, is an umbrella term for a number of different problems that create an inflammatory infection in the female reproductive system. PID is almost always the direct result of a sexually transmitted disease, such as gonorrhea or chlamydia, and is responsible for about 100,000 cases of female infertility per year.
All of these conditions can cause blockage to the fallopian tubes by having adhesions, scar tissue, tumors or polyps form inside the path of the tube. The fallopian tubes may also become stuck to other parts of the internal body; the bladder, ovaries, uterus, bowels, ect. Damaged fallopian tubes can become twisted or the walls of the tubes themselves may adhere together causing a total blockage.
Partially damaged fallopian tubes may remain open enough for pregnancy to occur, but a partial blockage increases the risk for ectopic pregnancy. The fallopian tubes are very thin to begin with, it does not take much for them to become blocked, preventing the ova from traveling through. Studies have shown that low progesterone levels, smoking and use of fertility medications may alter how the fallopian tubes function, which increases risk for ectopic pregnancy. Any of the conditions above may cause a partial tubal blockage as well, which also increases risk for ectopic pregnancy.
Diagnosing Blocked Fallopian Tubes
There really are no outward signs that will let you know if you are suffering from blocked fallopian tubes. If you have ever suffered from pelvic inflammatory disease, there is however a very good chance that your tubes are blocked, as doctors estimate that at least three out of four women that have had a sexually transmitted disease do suffer from tubal blockage.
The primary indicator that there is a blockage is an inability to conceive. Fortunately, there are medical tests that detect any abnormalities or blockages. If there is evidence of some type of blockage to the tubes, further investigation is generally performed using a laparoscope which will help the doctor actually see into the fallopian tubes. Here are details on how blocked fallopian tubes are diagnosed…
Hysterosalpingogram is an X-ray test, using a contrast dye to view any obstruction in the fallopian tubes. The dye is inserted through a thin tube that is placed up through the vagina, into the uterus. Filling the uterus with this dye will then spill into the fallopian tubes. X-rays are then taken to determine if there is an injury or abnormal shape of the uterus and fallopian tubes, including obstruction in the tubes. This test is the number one test performed to determine if there is a blockage in the fallopian tubes.
This test is similar to hysterosalpingogram because chromotubation includes dye being passed into the uterus and fallopian tubes as well. This test is performed during laparoscopy, so that doctors can see the dye spilling from the fallopian tube. The dye used for this procedure cannot be seen on an X-ray, it is blue in color. This test is considered the most reliable way to determine fallopian tube blockage, but does require surgery.
This is a non-invasive procedure where ultrasound imaging is used to determine if there are any abnormalities of the reproductive organs. This type of test is not always a reliable way to determine fallopian tube blockage since the tubes are so small. This test may help to determine hydrosalpinx or other issues such as uterine fibroids.
Medical Procedures to Open Blocked Fallopian Tubes
Thousands of women are diagnosed with blocked fallopian tubes each year and the number one question on their minds…how can I reopen them? There are many options for healing the fallopian tubes and in many cases they can become open once again. It is important to recognize that the fallopian tubes are about the size of a spaghetti noodle in width. Once they are damaged it may be difficult to reverse that damage. They are very delicate. Any sort of trauma can alter their function and damage the tubal tissues. Below are a variety of medical options for reopening the fallopian tubes.
Tubal surgical procedures can either be done by open abdominal surgery or laparoscopy (small incision).
This procedure is the removal of part of the fallopian tube. This is commonly performed for hydrosalpinx prior to IVF. According to Fertility and Sterility, untreated hydrosalpinx makes IVF half as likely to be successful.
This procedure is performed when the end of the fallopian tube is blocked by hydrosalpinx. The surgeon creates a new opening in the fallopian tube entrance nearest the ovary. The success of this procedure is often temporary and often scar tissue reforms causing another blockage within 3-6 months of the procedure.
This option may be performed on women with damage to the fimbriae. If the fimbriae and its cilia are stuck together by scar tissue, which is preventing the ova from being picked up, a fimbrioplasty may be recommended. This procedure rebuilds the fimbriae. Very few doctors are experts in this type of procedure and medical insurance often does not cover the cost of this procedure. Fimbrioplasty is now recommended in select cases over salpingostomy, which has been shown to be less successful.
The above procedures have about a 20-30% pregnancy success rate.
Selective tubal cannulation
This procedure is performed for proximal tubal occlusion (where the tube meets the uterus). Guided by hysteroscopy or fluoroscopy, doctors insert a catheter through the cervix, uterus and into the fallopian tube. This is non surgical procedure and has a 60% pregnancy success rate.
Tubal ligation removal, known as tubal reanastomosis
Reversal of a tubal ligation is a surgical procedure that is done with the assistance of a microscope and is generally performed in a hospital setting or outpatient surgical facility. The surgeon removes the portion of the fallopian tube that was tied or cauterized in the original surgery and reattaches the two ends to make a complete tube. This procedure has a 75% pregnancy success rate.
During surgery doctors may clip away adhesions from the fallopian tubes, ovaries and uterus so the reproductive organs can move freely once again.
Risks for Fallopian Tube Surgery and Procedures
Regrowth of scar tissue and adhesion. Any kind of surgery runs the risk of these types of formations. The tubes may become blocked again or adhered to the abdominal wall, other parts of the reproductive organs, or other organs in the surrounding location, for example the bladder. Scar tissue may also form on other parts of the abdominal cavity, including the reproductive organs due to the surgical procedure.
Opening the abdomen runs the risk of pelvic infection.
There is a great risk for ectopic pregnancy.
While surgery is a common treatment for blocked fallopian tubes, there are natural options which can have great results without causing additional scar tissue to form.
Natural Therapies for Fallopian Tube Health
1. Fertility Cleansing
Fertility cleansing helps to cleanse the entire reproductive system and increase circulation to the reproductive organs. Starting your natural fallopian tube therapy should begin with fertility cleansing. The herbs in this cleanse are absorbed into the body and go to work where they are needed. Fertility Cleansing creates a “clean slate” within the body that helps the body to respond and utilize other natural remedies better.
2. Systemic Enzyme Therapy
Systemic Enzyme Therapy is a method for helping the body clear itself of excess tissue, breakdown scar tissues, cleanse the blood, increase circulation to the reproductive organs and reduce immunological response. Enzyme therapy consists of using systemic enzymes (enzymes naturally found in the body) to help the body reduce inflammation, occasional pain, reduce scar tissue build up and more. Traditionally systemic enzymes have been used by athletes to help them recover, elderly wanting to reduce the effects from arthritis, people suffering from autoimmune issues and the list goes on.
Systemic Enzyme Therapy may help to reduce the scar tissue that are blocking your fallopian tubes. Specific systemic enzymes help to eat away and reduces the fibrin (the material that makes up scar tissue) over time. This type of therapy is an extremely promising for helping to reducing scar tissue and inflammation.
3. Abdominal or Fertility Massage
Massage is another natural therapy that could help support fallopian tube health. Massage helps to increase circulation and break up adhesions. Massage provides a great non-intrusive option for women with blocked fallopian tubes.
Benefits of Massage for Fallopian Tube Health:
Helps the body to clear blocked fallopian tubes*
Massage helps to break up scar tissue*
Increased circulation aids in tissue elimination*
Helps to reduce inflammation*
Helps the body to loosen tight or twisted tissues*
5. Herbal Therapies
There are many herbs that have been traditionally used to help support fallopian tube health. Below are actions that herbal therapies may have and below that is a section on herbs that have been found to have those actions. We are looking at 4 key actions which work to reduce infection, inflammation, promote healthy circulation and work to support hormonal balance.
Antibiotic: The antibiotic acting herbs help to clear out any infection that may exist in the reproductive system or fallopian tubes. Supporting immune function with antibiotic herbs may be important if there is a history of PID, STD’s, abdominal surgery, or endometriosis.
Anti-inflammatory: Anti-inflammatory herbs help to reduce inflammation, which in turn reduces pain and works to reduce further scar tissue production. If inflammation persists in or around the fallopian tubes, scar tissue may form.
Circulatory: There are herbs that help to increase blood flow through the reproductive organs. Healthy circulation to the reproductive organs is vital to healing the fallopian tubes. This is because fresh healthy blood will bring in vital nutrients, enzymes and oxygen for healing cells. Once the cells have used up what they need and have renewed or have replaced old damaged or unhealthy cells, the metabolic waste (damaged tissues) is removed from the body.
Hormone Balancing: Remember that hormonal balance is essential for proper fallopian tube function. When working to support fallopian tube health, we always want to include some herbs that support hormonal balance.
Blocked fallopian tubes are one of the main causes of infertility today. There are many natural options to help your body support normal fallopian tube function such as massage, enzymes and herbs. If you think you may have blocked fallopian tubes consult with your doctor so you can get an HSG test to determine if you have fallopian tube blockages. Once you have the diagnosis and location/severity of the blockages it will be easier to determine which route to take, whether it be a natural therapy or IVF.