What You Should Know About Fertility, HSG Tests, and Blocked Fallopian Tubes
Millions of Americans have experienced (or will experience) infertility. According to the National Institutes for Health, about 9 percent of men and 11 percent of women have had fertility problems. And while there are numerous reasons why—infertility can be caused by endometriosis; polycystic ovarian syndrome, or PCOS; or inadequate hormone levels— one of the most common causes is damage to the fallopian tubes. Over 30 percent of those diagnosed with infertility will have this condition.
But what is tubal infertility—and how is it diagnosed and treated? From HSG tests to the cause of blocked fallopian tubes, here's everything you need to know.
What Causes Blocked Fallopian Tubes?
Fallopian tube blockage is usually caused by scar tissue—which could be from pelvic infections or endometriosis—or by collection of fluid in the tubes, called hydrosalpinx.
How Do Blocked Fallopian Tubes Affect Fertility?
Conception occurs when sperm fertilizes an egg in the fallopian tubes. If the fallopian tubes are blocked and the egg released from your ovaries can't pass through the blockage, the egg and the sperm can't meet—and fertilization cannot occur.
"Fallopian tubes function by moving an ovulated egg from the ovary towards the uterus, using brush-like projections called cilia" says Dorette Noorhasan, M.D., a reproductive endocrinologist, medical director and the co-founder of CCRM in Dallas-Forth Worth. "But when the fallopian tubes are blocked, these cilia fail to function normally and the transport of eggs and embryos is impaired, causing infertility and/or ectopic pregnancies."
How Are Fallopian Tube Blockages Diagnosed?
Doctors typically use two different methods for diagnosing blocked fallopian tubes: HSG tests and laparoscopy.
The most common—and least invasive—way to diagnose a fallopian tube blockage is via a HSG test, or a hysterosalpingogram. During a HSG test, dye is injected into the fallopian tubes, allowing the specialist to see the path of the tubes and identify a blockage, if one exists. No anesthesia is required, Dr. Noorhasan says, and the side effects of HSG testing are minimal. Some need over-the-counter pain relievers for cramping, while others do not need any medical intervention at all.
When should an HSG test be done? While HSG tests can be conducted at any time, the American College of Obstetricians and Gynecologists says it is best to schedule the procedure during the first half of your menstrual cycle, as this timing reduces your change of being pregnant.
How much do HSG tests cost? The cost of a HSG varies, depending on which part of the country you live in and what is covered by your insurance. Dr. Noorhasan says that many insurance carriers will cover diagnostic testing, including HSG testing, making you responsible for your co-pay and deductible only. However, you should check with your insurance carrier.
Another way to see if the tubes are blocked is by laparoscopy. In this procedure, a specialist inserts a tiny scope into a small incision near the woman's navel. During this surgery the doctor injects dye into the uterus. If the dye spills out the ends of the fallopian tubes, there's most likely not a blockage. Most physicians prefer HSGs to laparoscopy for diagnosing blocked fallopian tubes.
Treating Blocked Fallopian Tubes
The only way to "unblock" fallopian tubes is to remove the scar tissue, Dr. Noorhasan says. "This is typically done laparoscopically, via several small incisions in the belly. In severe cases, a laparotomy (opening the belly) may be necessary to take down the scar tissue." However, these surgeries are not without complication.
"Sometimes the scar tissue is so dense that it cannot be taken down," Dr. Noorhasan says. "In some cases, the procedure itself is problematic. New scar tissue can form after surgery." As such, the key to maximizing your chances of success with this type of surgery is to obtain a referral for a specialist who is skilled in tubal surgery. Ask your gynecologist for a referral and check with your state medical licensing board for the names of qualified specialists in your area.
Thank you for this article! I should notice that it really helpful. Together with my husband we have been trying to get our child naturally for a long time. But nothing worked! I was desperate. And now I have already known about this diagnosis. My fertility doctor said that, unfortunately, I have a total fallopian tubes blockage and there is no chance to get our kid naturally. She gave us two options – to go through the IVF procedure or use the help of the surrogate motherhood. But I felt that my body is too weak for this and it seems that I am not healthy enough. So we decided to find the most suitable Center for Human Reproduction where will be quite an affordable price. And we found one! The Biotexcom clinic in Kiev, where the cheapest program costs about 30k Euros. We are going to make the first visit there but I hope that everything will be ok.Read More