Overview

The fallopian tubes connect the ovaries to the uterus. When one or both are blocked or damaged, the egg and sperm cannot meet, making natural conception very difficult. Tubal factor accounts for up to 30% of female infertility cases.

Symptoms

Blocked tubes often cause no symptoms. Underlying causes may produce pelvic pain, painful periods, pain during intercourse, or unusual discharge. Hydrosalpinx (fluid-filled tube) may cause pelvic discomfort.

Causes & Risk Factors

• Pelvic Inflammatory Disease (PID) — chlamydia or gonorrhoea scarring
• Endometriosis
• Previous abdominal or pelvic surgery
• Prior ectopic pregnancy
• Genital tuberculosis

Complications

• Infertility — bilateral blockage prevents natural conception
• Ectopic pregnancy risk with partial blockage
• Hydrosalpinx significantly lowers IVF success if untreated

Diagnosis

• HSG (hysterosalpingography) — X-ray dye study
• HyCoSy — ultrasound alternative; no radiation
• Laparoscopy with chromopertubation — gold standard

Treatment

• IVF — most effective; completely bypasses the fallopian tubes
• Laparoscopic surgery — to remove adhesions or open blocked tubes
• Hydrosalpinx management — salpingectomy or clipping before IVF
• Tubal cannulation — for proximal blockages
• Antibiotics — for active infections before any procedure

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