Tubal Factor Infertility: What Are Your Options?

On the path to parenthood, there can be many factors that may prevent you from getting pregnant as quickly as you had planned or hoped. One possible diagnosis is tubal factor infertility which affects approximately 20 to 25% of couples who are experiencing infertility. This includes cases where a woman’s fallopian tubes are completely blocked, or she has either one blocked tube and/or no blockage but some sort of damage or scarring that is preventing her and her partner from conceiving. In this blog, we’ll delve into this condition, exactly what it is, how it does and doesn’t impact your fertility and the options you can explore so you can expand your family.

What is Tubal Factor Infertility?

In a typical “trying to conceive” cycle, the ovary releases an egg into the fallopian tube where it would wait to be fertilized with sperm. The fertilized egg, the embryo, would then travel to the uterus and attach itself to the uterine lining (also known as implantation). This would mean you are pregnant.

Since tubal factor infertility is when a woman’s Fallopian tube(s) are compromised either through scarring, damage or blockage, it can block a clear pathway in two ways:

1. For the sperm to reach the egg in order to fertilize it.
2. If the egg is able to be fertilized and an embryo is created, it may not be able to reach the uterus so that it can properly implant.

What causes your fallopian tubes to be blocked?

There are various potential causes of tubal factor infertility but the most common are the following:

• Previous abdominal surgery
• Ruptured appendix
• Pelvic inflammatory disease (PID), an infection of the female reproductive organs
• Endometriosis, a disease in which the tissue that normally lines the uterus is found outside the uterus
• Sexually transmitted disease (STD), such as gonorrhea and/or chlamydia
• Ectopic pregnancies previously, which is when the embryo grows outside of the uterus

What are the signs and symptoms of blocked fallopian tubes?

Unless you have a had a tubal ligation, where you electively decided to have your “tubes-tied”, many women do not necessarily realize that there is an issue with their fallopian tubes until they begin actively trying to conceive.

However, if you’ve had any of the above, such as endometriosis or PID, you may have experienced painful cramps or lower abdominal pain.

There are two tests recommended to diagnose blocked fallopian tubes and they are:

Hysterosalpingogram (HSG): This is a form of an X-ray that uses a dye that is gently passed through the cervix and into the fallopian tubes to see if they are blocked. This test is just one piece of the puzzle. If the HSG shows that your tubes appear to be opening, there may still be blockage or scarring within the lining of the tube.

Laparoscopy: This is a minimally invasive surgical procedure that gives your doctor a more direct view of the fallopian tubes. While the HSG provides an X-ray, the laparoscope can give your doctor additional insight into whether the tubes are blocked or if there are other issues such as scar tissue or adhesions.

Can you still ovulate if your fallopian tubes are blocked?

What’s encouraging is while your fallopian tubes may or may not have an issue, this does not impact the actual act of ovulation. The concern is more that if you regularly ovulate monthly, and you have blocked tubes, your egg and the sperm may not be able to meet for fertilization to happen. This doesn’t mean that you’re not ovulating or that there is an ovulation problem.

If, however, you’re having irregular periods or have been using ovulation prediction kits or some other form of trying to pinpoint your ovulation time such as a BBT Thermometer and are having difficulty finding your most fertile period, you may want to mention this to the doctor.

Can you be a surrogate after tubal ligation?

Yes! It could actually mean you’re a great candidate for surrogacy; you have proven fertility and are most likely done building your own family, both of which are important qualities for a gestational carrier. Plus – and this is also a critical point – it’s extremely unlikely you’ll become pregnant on your own before the embryo transfer. Because the egg will be from the intended mother or an egg donor, your ovaries and fallopian tubes will not be involved in the process at all.

Is IVF Successful with Blocked Fallopian Tubes?

When trying to conceive, you have various treatment options and you should feel comfortable reviewing them with your doctor to decide which works best for you. For example, in vitro fertilization (IVF) is an ideal option. It’s the process of when eggs are retrieved from the woman, then mixed with sperm from her husband, partner or male donor in a laboratory and then any resulting embryo(s) are transferred to the woman's uterus.

This is considered an ideal option to tubal factor infertility because it completely bypasses the fallopian tubes.

It’s important to note that age is a factor with IVF even in cases of tubal factor infertility. Speak to your doctor about the success rates for your age group and if he or she recommends this as an option.

Treatment of Tubal Factor Infertility

If your doctor does not recommend IVF or you’re not ready to pursue fertility treatment, there are some other options to potentially repair your fallopian tubes. They are:

Tubal Cannulation: This is an outpatient procedure and uses a catheter and balloon to gently unblock your tubes.

Fimbrioplasty: This is a laparoscopic procedure that aims to rebuild the “fimbriae”, which describes the finger-like ends of your fallopian tube to sew them back together. This is recommended for those who have only minor blockage.

Salpingectomy: This is the surgical removal of a damaged fallopian tube.

When you want to have a family, you don’t want any roadblocks standing in your way. Still, what is comforting when it comes to tubal factor infertility is you have several options to choose from that can help create alternative pathways for your eggs and embryos to get to where they need to be. Speak to your doctor, talk to your partner, and contact us so we can help you talk through all of your family building options to bring you one step closer to becoming the parent you aim to be.