How does patency of the fallopian tubes affect fertility?

The fallopian tubes are the part of the female reproductive organs that connect the ovaries to the uterus. During ovulation, which takes place around the middle of the menstrual cycle, the fallopian tubes carry the released egg cell from the ovary to the uterus. Most often, conception also takes place at this point.

Obstruction of the fallopian tubes is one of the causes of infertility in women. Blocked fallopian tubes prevent the egg cell and the sperm cell from approaching each other or obstruct the already fertilised cell's path to the uterus. For this reason, the embryo will not be able to implant in the endometrium. The problem even affects 30% patients who come for a fertility assessment .

The problem even affects 30% patients who present for fertility assessment .

What can cause an obstruction of the fallopian tubes?

The fallopian tubes can become blocked for a number of reasons which include:

past infectionswhich lead to the creation of adhesions within the fallopian tubes,
appendicitis and complications following appendectomy surgery,
sexually transmitted diseases, such as gonorrhoea or chlamydia,
endometriosis, a condition in which the lining of the uterus grows outside the uterine cavity, which can cause obstruction of the fallopian tubes and impaired ovulation,
abdominal surgery, such as the removal of uterine myomas and ovarian cysts,
congenital malformation of the fallopian tubes,
incorrect application IUD,
ectopic pregnancy,
tumours oviducts.

All of these conditions or procedures can have a direct impact on the fallopian tubes.

As a result, adhesions, mucous plugs, nodules or scar tissue form and block the fallopian tubes.

Fallopian tube obstruction and ectopic pregnancy

A common complication of obstructed fallopian tubes is ectopic pregnancy. If the fallopian tube is partially blocked, the egg cell will be able to be fertilised, but may get stuck in the tube after combining with the sperm. This results in an ectopic pregnancy.

The only treatment is to stop the course of the pregnancy, which threatens the woman's health and life. If, after treatment, infertility occurs and the woman wants to fulfil her dream of motherhood, doctors will suggest in vitro fertilisation.

How to check the patency of the fallopian tubes?

Ultrasonographic hysterosalpingography, or Sono HSGis a type of examination used to check the patency of the ovaries. The procedure takes place in a gynaecological chair. During HSG, the doctor injects a contrast medium into the uterus and fallopian tubes, which allows the inside of the uterine cavity and fallopian tubes to be seen on a monitor. During the administration of the fluid, the specialist performs a vaginal ultrasound examination.

Examination of the patency of the fallopian tubes takes place in the first half of the menstrual cycle. If the patient wishes, it can be carried out under general anaesthesia. Sometimes the fluid used for the procedure unclogs the fallopian tube, so the procedure may also have a therapeutic function.

How effective is the treatment of obstructed fallopian tubes?

In approximately 4 - 15% patients, the fallopian tubes are successful.

Treatment of obstructed fallopian tubes

If the fallopian tubes are suspected of being obstructed, the doctor can use laparoscopic surgery to unblock them. The procedure is reimbursed by the National Health Fund. The method is much less invasive than traditional surgery, as it does not require opening the abdominal cavity. Only two small incisions are needed for the surgeon to insert a camera and instruments.

The effectiveness of treatment depends on the severity of the problem. On average, 4 - 15% patients succeed in unblocking the fallopian tubes. As a result, a few months after the treatment, you will be able to try to have a baby by natural methods or with a little medical support, i.e. hormonal stimulation or monthly cycle monitoring. In case of failure, there is no need to give up. A woman whose fallopian tubes are not fully obstructed may benefit from a procedure of in vitro.

Authorisation of content:

Artur Kobielski, MD, PhD - specialist gynaecologist-obstetrician from the InviMed clinic in Katowice.