What You Need to Know About Blocked Fallopian Tubes

For those trying to get pregnant, the fallopian tubes play an integral role in reproductive health and the conception process.

What are they exactly? "Fallopian tubes are the tubular structures on either side of the uterus in which egg and sperm meet and fertilization occurs," explains Pinar Kodaman, M.D., Ph.D., a Yale Medicine reproductive endocrinologist and infertility (REI) specialist. "At the time of ovulation, the fallopian tubes coax the egg(s) into their lumen (opening) with fingerlike projections called fimbriae."

But fallopian tubes can become blocked and make conception difficult. A review of research from 2021 indicated that tubal infertility, which involves blocked fallopian tubes, accounts for anywhere from 11% to 67% of infertility diagnoses.

"Blocked fallopian tubes are a common cause of infertility, and if patients are unaware that they have blocked tubes, they may waste time trying to get pregnant without assistance when the use of fertility treatment is necessary to achieve a pregnancy," says Rachel Gerber, M.D., a board-certified OB-GYN and REI specialist at RMA of New York.

Dr. Gerber adds that blocked fallopian tubes also increase the risk of an ectopic pregnancy. This non-viable and life-threatening pregnancy occurs when the fertilized egg implants outside the uterus.

How does a blocked fallopian tube happen, and what can you do about it? Experts share answers to common questions about blocked fallopian tubes, including the chances of getting pregnant if you have one.

What Are Blocked Fallopian Tubes?

As the name implies, blocked fallopian tubes are "physically or functionally obstructed," explains Dr. Kodaman.

"Blocked fallopian tubes do not allow for normal passage of egg, sperm, or the early embryo through their interior channel, resulting in infertility and increased risk of tubal ectopic pregnancy," she adds.

Blocked Fallopian Tubes Causes

There are several causes of blocked fallopian tubes, Dr. Kodaman points out. Sometimes, they're blocked at birth. Other times, they develop because of conditions, such as:

• Infections like gonorrhea and chlamydia
• Inflammation related to endometriosis
• Scar tissue (adhesions) from previous abdominal/pelvic surgery
• Intra-abdominal infections

Other potential causes, according to Dr. Gerber, include:

• Prior ectopic pregnancy
• Previous tubal ligation
• Certain fibroids

Blocked Fallopian Tubes Symptoms

Often, there are no signs of blocked fallopian tubes, says Olivia Dziadek, M.D., a gynecological surgeon with UTHealth Houston. Someone may not know they have a blocked tube until they start trying to conceive and have difficulty. But other times, there are some red flags—often related to the cause of the blocked fallopian tubes.

"Women who have tubal blockage from endometriosis or pelvic inflammatory disease may experience pelvic pain," Dr. Dziadek says.

Blocked Fallopian Tubes Diagnosis

Providers typically diagnose a blocked fallopian tube using a screening test known as a hysterosalpingogram (HSG). "During an HSG, dye is injected into the uterus through the cervix, and X-rays are taken to determine if that dye passes into the tubes on both sides of the uterus and spills freely into the abdomen," says Dr. Kodaman. A provider will suspect a tubal issue if the dye does not enter the tubes or can't freely pass and spill out. 

An HSG is part of a fertility work-up that is typically done when someone meets criteria for infertility—an inability to conceive after trying for one year for those under 35 or 6 months for those 35 or older. A health care provider may recommend the test for someone 40 or above before they try to conceive, as well as for someone with risk factors for infertility or fallopian tube disease, including a history of pelvic infection, endometriosis, prior ectopic pregnancy, or ruptured appendix. 

Another way to diagnose blocked fallopian tubes? "Tubes can be assessed for health and patency during surgery, or laparoscopy, when dye is passed through the cervix into the uterus (a procedure called chromopertubation) and the tubes are directly visualized for fill and spill," says Dr. Kodaman. But Dr. Kodaman adds this isn’t typically recommended as the first step. “Laparoscopy with chromopertubation is the gold standard (better test) to assess for tubal disease, but because it requires a surgical procedure under general anesthesia, it is not usually the first step for evaluation of the tubes.”

In some cases, what appears to be a blockage may not be one at all. "Proximal blockage, or blockage of the tube near the uterus where the fallopian tube originates, can sometimes be due to spasm and therefore may not represent a true blockage," says Dr. Kodaman. That's why an accurate diagnosis through testing to see the location and severity of the blockage is critical for treatment.

Complications of Blocked Fallopian Tubes

Blocked tubes can have their share of complications. Dr. Gerber says the complications of blocked fallopian tubes may include:

• Infertility
• Infection if fluid or bacteria gets trapped in the damaged or blocked fallopian tubes
• Increased risk of ectopic pregnancy. Also, "ectopic pregnancies can continue to grow in the tubes until the tubes rupture, which can cause life-threatening hemorrhage if not treated" right away, says Dr. Gerber.

Blocked Fallopian Tubes Treatment

The good news is people with blocked fallopian tubes have options for treatment. 

Tubal cannulation can be attempted for proximal blockage that happens near the uterus. During this procedure, a catheter is inserted into the vagina and guided over a wire. Blocked areas are opened up using a balloon on the catheter or with the wire.

For patients who have distal blockage (occurring at the end of the fallopian tube near the ovary), other procedures like neosalpingostomy and fimbrioplasty may be performed. But that depends on the extent of the disease, says Dr. Dziadek.

Other times, removal of the fallopian tube is recommended so that a patient can undergo reproductive assistance like in vitro fertilization (IVF). Dr. Gerber explains, "It is sometimes recommended to surgically remove the fallopian tubes prior to implanting an embryo if there is fluid buildup in the fallopian tube, also known as a hydrosalpinx."

Fertility Prognosis

A blocked tube can be troubling for someone who hopes to become pregnant, but pregnancy can still be possible.  

"If the blockage is successfully reversed surgically and the tube remains open and functional after healing is complete, the chances of pregnancy are essentially back to normal," says Dr. Kodaman. "However, any pregnancy following tubal surgery must be followed very closely from the start to make sure that it is in the right place and not an ectopic pregnancy, the chances of which remain elevated after repair of tubal blockage."

But a person may also be able to become pregnant with a blocked tube. "Pregnancy is more likely if the tube is only partially blocked or damaged and if only one of the two tubes is blocked," says Dr. Gerber.

The location of the blockage can also have an impact. If the tube is blocked at the distal end, which is further away from the uterus, it’s unlikely the egg will make it into the tube where fertilization can occur, explains Dr. Kodaman. "Furthermore, if the tube is blocked at its far end and the tube is full of fluid, or hydrosalpinx, this fluid can prevent successful pregnancy from occurring, even with IVF, due to backwashing of the fluid into the uterine cavity,” adds Dr. Kodaman. Swollen, blocked tubes (or hydrosalpinges) are often surgically removed via salpingectomy before IVF to allow for the best chances of pregnancy.

Despite the severity of the blockage, IVF can increase the chances of pregnancy in someone with a blocked tube that can’t be fixed. "IVF bypasses the blocked tube or tubes by allowing egg and sperm to meet outside of the body," explains Dr. Kodaman.

The Bottom Line

Blocked fallopian tubes can make pregnancy difficult, but with proper diagnosis and treatment, conception is certainly possible. Anyone with risk factors for infertility or fallopian tube disease should speak to their health care provider before trying to conceive. Those 35 and under who have tried to conceive for one year unsuccessfully, as well as those 35 or older who have tried for six months, should get evaluated by their health care provider.