The fallopian tubes carry the egg towards the uterus, and are where sperm usually meet it. Tubes can be blocked or damaged by infection, surgery or endometriosis. Tests can check them, and there are options even when both tubes are blocked.
What the fallopian tubes do
There are two fallopian tubes, one on each side of the uterus. After an egg is released from the ovary, the nearby tube picks it up. Sperm swim up through the uterus into the tube, and fertilisation usually happens there. The tube then moves the early embryo into the uterus over a few days.
If a tube is blocked or damaged, the egg and sperm may not be able to meet, or an embryo may not reach the uterus.
Common causes
- Pelvic infection. Pelvic inflammatory disease (PID) can scar the tubes. Chlamydia is a common cause, and it often has no symptoms, so many people don't know they have had it.
- Previous surgery in the abdomen or pelvis, including surgery on the tubes, ovaries or appendix.
- Endometriosis, which can cause scarring and adhesions around the tubes.
- A previous ectopic pregnancy, where a pregnancy grew in the tube, or its treatment.
- Tuberculosis of the genital tract. This is uncommon in many countries but is still seen in India, and is worth mentioning to your doctor if you have had TB.
Good to know. Many people with tubal damage had no idea. An old, silent infection is nobody's fault, and it doesn't define your options.
How the tubes are checked
| Test | How it is done | Notes |
|---|---|---|
| HSG (hysterosalpingogram) | Dye is passed through the cervix and X-ray pictures show whether it flows through the tubes | Done after a period and before ovulation; can be uncomfortable |
| HyCoSy (contrast ultrasound) | A similar idea using a special fluid and a transvaginal ultrasound, without X-rays | Also shows the uterus and ovaries |
| Laparoscopy with dye | Keyhole surgery under anaesthesia, with dye passed through the tubes | Usually offered when other problems, such as endometriosis, may need looking at or treating at the same time |
A doctor will usually suggest HSG or HyCoSy first if you have no known risk factors, and laparoscopy if there is a history that makes problems more likely. Sometimes a tube looks blocked on a test because of a temporary spasm, so results are read alongside your history.
Hydrosalpinx, and why it matters before IVF
A hydrosalpinx is a tube that is blocked at the far end and has filled with fluid. It is usually caused by past infection.
This matters for IVF because the fluid can leak back into the uterus and make it harder for an embryo to implant. Guidelines generally advise that, before IVF, a doctor discusses treating a hydrosalpinx. This usually means removing the affected tube (salpingectomy) or blocking it close to the uterus, by keyhole surgery.
It can feel strange to remove a tube when you are trying to conceive. Ask your doctor to explain why it is suggested in your case, and what the alternatives are.
Options
The right option depends on which part of the tube is affected, how badly, whether one or both tubes are involved, your age, and the male partner's results.
- One open, healthy tube. Natural conception, or treatment such as IUI, may still be possible, because IUI needs at least one open tube.
- Tubal surgery. In selected cases, especially minor damage near the ovary end, surgery may open a tube. Success depends heavily on the type of damage, and surgery raises the chance of a later ectopic pregnancy.
- IVF. IVF bypasses the tubes completely, because eggs are collected from the ovaries and an embryo is placed directly in the uterus. It is often the main option when both tubes are blocked or badly damaged.
Under the ART (Regulation) Act, 2021, IUI and IVF must be carried out at a registered clinic. You can check a clinic yourself with our ART registry guide.
Caution. Damaged tubes increase the chance of an ectopic pregnancy, where a pregnancy grows outside the uterus, usually in a tube. This can be life-threatening. Know the warning signs below.
When to see a doctor
See a doctor if you have had pelvic infection, chlamydia, pelvic surgery, endometriosis or a previous ectopic pregnancy and are trying to conceive, even before the usual 6 to 12 months.
If you might be pregnant and have any of these, call 112 or go to the nearest hospital straight away:
- pain low in the tummy, especially on one side
- vaginal bleeding or brown discharge
- pain in the tip of the shoulder
- feeling dizzy, faint, or collapsing
Sources
This is general information, not medical advice. It can't account for your history. Please talk to a doctor about your own situation. Medical disclaimer
Severe pain, heavy bleeding or fainting? Call 112 or go to the nearest hospital.