
Occasionally the fallopian tubes can become blocked. The most common reason for tubal blockage is pelvic infection (pelvic inflammatory disease), which is most commonly acquired as a sexually transmitted infection. The commonest cause is chlamydia infection.
Blocked fallopian tubes are found in 10-15% of infertile women
There are other possible causes of tubal blockage
· Endometriosis: where the tubes are blocked due to adhesions
· Mechanical blockage: sometimes due to the presence of fibroids pressing on the tubes
· Adhesions from previous surgery
Presentation:
The majority of women have no symptoms but some will present with
Pelvic pain due to enlargement of the fallopian tube. Alternatively the swollen fallopian tube may be found during investigation for infertility
Investigations:
Often your doctor will ask you to have a hysteroalpingogram (this is an x-ray test used to visualize dye put through the fallopian tubes), or a laparoscopy.
Management
The aims of management are to
1. Restore the anatomy of the fallopian tube
2. Restore fertility
These objectives are met using operative laparoscopy
It is relatively easy to open up the tube and let the fluid out; fertility on the other hand depends on the degree of damage to the end of the fallopian tube.
The degree of damage is usually graded I-IV with one being the least and IV the worst.
Fertility rates after repair range from 19-48%
In some cases depending on the degree of damage doctors may advise that the fallopian tubes be clipped or removed to improve chances of success with IVF