Will the fallopian tubes be blocked if there is no inflammation?

The fallopian tube is a unique organ in women. As the name suggests, its main function is to transport eggs. Therefore, the fallopian tube is also an essential organ in the reproductive system. However, in life there are some women who cannot get pregnant, mainly because of blockage of the fallopian tubes. Once the fallopian tubes are unblocked, pregnancy is still possible. So, if there is no inflammation, will the fallopian tubes be blocked?

Inflammation is the main cause of fallopian tube obstruction, but the absence of inflammation cannot rule out the possibility of fallopian tube obstruction.

Fallopian tube blockage is the main cause of female infertility, accounting for 25% to 35% of female infertility, and the main cause of fallopian tube damage is pelvic inflammatory disease (PID). The incidence of secondary fallopian tube obstruction is directly related to the incidence of PID. Reproductive capacity after fallopian tube reconstruction depends on the site and extent of fallopian tube damage. Women with extensive fallopian tube damage have a lower chance of becoming pregnant, and IVF can improve their pregnancy rates.

Causes

1. Infection

Most cases of fallopian tube disease are secondary to infection, particularly pelvic inflammatory disease (PID). Other possible causes of infection include a perforated appendix, infection after abortion, or postoperative complications, such as endometriosis and inflammatory states caused by surgery, which can lead to occlusion of the fallopian tubes due to adhesions. Rarely, embryologically absent fallopian tubes are a factor in infertility, and the final cause may also be iatrogenic, such as tubal ligation.

Although pelvic inflammatory disease can be caused by a variety of microorganisms, chlamydia is the main cause of infertility. Damage to the fallopian tubes may already exist before the application of antimicrobial therapy. Sometimes the infection may be subclinical and exist in the fallopian tubes for months before diagnosis and treatment. This is in stark contrast to the acute onset of PID caused by Neisseria gonorrhoeae. It is now highly suspected that chlamydia infection damages the mucosa of the fallopian tube through immunopathological mechanisms, while Neisseria gonorrhoeae damages the fallopian tube through related cytotoxicity. Other latent infectious pathogens include Mycoplasma hominis and endogenous aerobic or anaerobic bacteria. Pelvic tuberculosis accounts for 40% of tubal infertility in developing countries.

Infectious abortion is another major risk factor for tubal infertility. Preoperative examinations include bacterial vaginosis and cervicitis. Culture and serological tests should be performed when necessary, and the test results should be understood before surgery. We routinely use preventive antibiotics after abortion.

2. Inflammation/adhesion

Tissue trauma caused by surgical operations can also lead to a pre-inflammatory state or even adhesions. The incidence of postoperative adhesions is approximately 75%, and laparoscopy cannot prevent the occurrence of adhesion sequelae. The application of adhesion barriers (such as anti-adhesion membranes) can reduce the occurrence of adhesions by an average of 50%. The removal of adhesions will increase the rate of infertility. If serious diseases exist, in vitro fertilization-embryo transfer (IVF-ET) may be the only option.

Clinical manifestations

Generally speaking, there are no typical symptoms. The most common manifestation is infertility. The fallopian tube plays an important role in transporting sperm, absorbing eggs and transporting fertilized eggs to the uterine cavity. Blockage of the fallopian tube hinders the passage of sperm and fertilized eggs, leading to infertility or ectopic pregnancy. If the fallopian tube obstruction is caused by pelvic inflammation, it may be accompanied by lower abdominal pain, back pain, increased secretions, pain during sexual intercourse, etc.