Blocked fallopian tubes
Why it matters
The fallopian tube is where fertilisation happens. If both tubes are blocked, natural conception cannot occur. If one is open, it can.
The most common cause, and why it is often silent
Previous pelvic infection, particularly chlamydia — which is asymptomatic in the majority of women while capable of causing tubal damage. Many women discover tubal blockage during fertility investigation with no history of a diagnosed infection.
Other causes: endometriosis, previous pelvic or abdominal surgery, previous ectopic pregnancy, and hydrosalpinx — a tube filled with fluid.
Symptoms
Usually none. This is the point most worth making. Blocked tubes typically cause no pain, no cycle disturbance and no symptoms of any kind.
You cannot rule this out by feeling well, which is why the trigger for investigation is time trying rather than symptoms.
How it is tested
HSG — hysterosalpingogram. Dye is passed through the cervix under X-ray to show whether tubes are open. Some women find it uncomfortable; a short procedure.
HyCoSy — a similar test using ultrasound rather than X-ray.
Laparoscopy with dye — direct visualisation, more definitive, and allows treatment at the same time. More invasive.
Testing is generally reserved for where there is reason to suspect tubal damage — previous infection, surgery, endometriosis, or ectopic pregnancy — rather than performed routinely on everyone.
Treatment
IVF bypasses the tubes entirely and is the usual approach for bilateral blockage.
Surgery may be considered in selected cases depending on the site and extent of damage. Outcomes depend heavily on what is found.
Hydrosalpinx is a specific situation: a fluid-filled tube can reduce IVF success, and removal or occlusion before IVF is commonly recommended. Ask about this specifically if a hydrosalpinx has been found.
One tube open
Pregnancy remains possible. The chance per cycle is reduced but not halved in any simple way — it depends on which side ovulation occurs and whether the remaining tube is healthy.
Prevention
Prompt treatment of pelvic infection. Testing for chlamydia with a new partner — it is asymptomatic in most cases, and both partners need treating to avoid reinfection cycling between you.
Reviewer note
This page describes standard practice. A specific guideline source for tubal assessment and hydrosalpinx management was not available to this audit and should be added.
Frequently Asked Questions
Can you get pregnant with blocked fallopian tubes?▾
Natural conception is not possible with both tubes blocked — the egg and sperm cannot meet. With one tube blocked and one open, natural conception is reduced but possible. IVF completely bypasses the fallopian tubes — eggs are collected directly from the ovaries — so bilateral tubal blockage is successfully treated with IVF. Any hydrosalpinx (fluid-filled blocked tube) must be treated before IVF.
How do you know if your fallopian tubes are blocked?▾
Blocked tubes produce no symptoms — no pain, no change in periods. The only way to diagnose them is testing. HyCoSy (ultrasound contrast test) or HSG (X-ray contrast test) are the standard first-line investigations. Laparoscopy with chromopertubation is the gold standard and also allows simultaneous treatment.
Can blocked fallopian tubes be treated without surgery?▾
For proximal (near-uterus) blockage, selective salpingography (threading a fine catheter into the tube under fluoroscopy) can unblock tubes caused by mucus plugs in approximately 70% of cases. For mid-tube or distal blockage, surgery (laparoscopy) is required. Hydrosalpinx requires surgical removal or occlusion before IVF. Complete bilateral tubal damage is best treated with IVF rather than surgical repair.