Fallopian Tube Diseases

Fallopian tube diseases at a glance

  • If a woman’s fallopian tubes are damaged, become blocked through infection or are malformed at birth, she may experience infertility.
  • Disease causing blocked fallopian tubes can prevent the essential reproductive functions of the sperm reaching the egg for fertilization in the fallopian tube and the fertilized egg from traveling through the tube to implant in the uterus.
  • The most common causes of fallopian tube disorders are pelvic inflammatory disease (PID), pelvic surgery that damages the tubes and conditions that block the tubes, such as birth defects, fibroids and endometriosis.
  • Treatment generally involves laparoscopy.
  • Even after surgical treatment, many women will need in vitro fertilization (IVF) to conceive.

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What are fallopian tube diseases?

Fallopian tube diseases and other conditions can affect the function of a woman’s fallopian tubes, which are two ducts that connect the ovaries to the uterus and serve as pathways for eggs and sperm. Damaged or blocked fallopian tubes are a major cause of infertility, either by preventing the sperm from reaching the egg the ovary has ovulated into the fallopian tube or by preventing a fertilized egg (an embryo) from traveling to the uterus to implant for a pregnancy.

Fallopian tube diseases are generally infections that damage the tubes by causing the formation of scar tissue. The primary cause is pelvic inflammatory disease (PID), which results from a bacterial infection of a woman’s reproductive organs (ovaries, uterus and fallopian tubes).

PID results from infections that ascend from the vagina and cervix and on to the upper parts of the reproductive tract. These infections are most often caused by sexually transmitted diseases, primarily chlamydia and gonorrhea. PID can result in a variety of conditions such as salpingitis and pyosalpinx that can damage the fallopian tubes.

Chlamydia, aside from being a factor in PID, can also directly infect the fallopian tubes and cause infertility. Other causes of fallopian tube diseases and disorders include:

  • Previous surgery in the pelvic region or lower abdomen
  • A rupture of the appendix
  • Use of an intrauterine device (IUD) that damages the opening to the fallopian tube
  • A previous ectopic pregnancy, in which the embryo implants outside the uterus, often in the fallopian tubes
  • Endometriosis, in which tissue normally shed during menstruation adheres to the fallopian tube
  • Uterine fibroids
  • Benign fallopian tube tumors
  • Primary fallopian tube carcinoma
  • Birth defects resulting in abnormal fallopian tubes or an abnormal uterus.

Symptoms of fallopian tube diseases

In many instances, a woman doesn’t know her fallopian tube(s) is blocked because there are often no symptoms. Infertility is often the only symptom of fallopian tube disease or blocked fallopian tubes.

A blocked fallopian tube may cause mild pain due to pressure from the buildup of scar tissue, which is experienced as constant, low-grade pain in the lower abdomen. However, other conditions not related to fallopian tube disease can also cause these symptoms.

Doctor discussed fallopian tube diseases with patient | Arizona Reproductive Medicine Specialists

Diagnosis & treatment of fallopian tube diseases

Physicians may suspect a diagnosis of fallopian tube disease or blocked fallopian tubes due to infertility, other symptoms of pain and/or information gathered in a medical history interview.

The first-line method of diagnosing fallopian tube damage is with imaging procedures to identify the blockage or scar tissue. Blood tests are sometimes used to detect antibodies specific to chlamydia, which suggests a past infection and possible tubal damage.

Hysterosalpingography (HSG)

Hysterosalpingography (HSG) is the most common imaging procedure to check for structural problems with the fallopian tubes. Hysterosalpingography is usually performed a few days after the woman’s menstrual period ends. It involves dye injected through the cervix into the fallopian tubes and X-rays that produce an image of the fallopian tube structure outlined by the dye.

Sonohysterography

Sonohysterography can also detect fallopian tube problems. In this procedure, a saline solution is injected through the cervix into the uterus, causing it to expand and allowing ultrasound imaging to reveal abnormalities. If the saline solution can be seen flowing into the fallopian tubes, it indicates the tubes are not blocked.

Hysteroscopy

Doctors use hysteroscopy to positively identify suspected fallopian tube damage or disease. A thin, lighted viewing tube called a hysteroscope is inserted through the vagina into the uterus to provide a view of growths that may be blocking the fallopian tubes. If a blockage such as a fibroid or a polyp is found, instruments can be inserted through the tube so the physician can remove them via minimally invasive surgery.

Laparoscopy

Laparoscopy can also positively identify and remove blockages in the fallopian tubes. A laparoscope, a tube with camera and light, is inserted through a small surgical incision and into the uterus. The physician can see into the fallopian tubes and if a blockage is present, can remove it using special instruments inserted through the laparoscope.

Surgery

Sometimes surgery is required to repair a fallopian tube damaged by infection or by an ectopic pregnancy. In most instances, even after surgery, the woman will need IVF to conceive. However, the surgery is beneficial to remove infection or other blockages to ensure the woman can carry a pregnancy successfully.

The procedures above carry some risks associated with invasive procedures, including blood loss, pain and tissue damage. Laparoscopy and surgery carry similar risks, plus the risk of reaction to anesthesia.