Blocked fallopian tubes are one of the most common causes of female infertility. The fallopian tubes carry the egg from the ovary to the uterus. If fallopian tubes are blocked, the egg cannot be fertilized by sperm. This can lead to difficulty getting pregnant or even infertility. However, there are steps that you can take to increase the chances of getting pregnant with blocked fallopian tubes.
If you’re one of the many couples struggling with infertility due to blocked fallopian tubes, don’t give up hope just yet!
This article discusses the seven key steps you can take to significantly increase your chances of getting pregnant.
Whether you’re just starting or have been trying for a while, these tips to getting pregnant with blocked fallopian tubes will give you the confidence and knowledge to take control of your fertility and get you one step closer to welcoming a new addition to your family.
What is the Role of Fallopian Tubes in Pregnancy?
Fallopian tubes are two tube-like structures or narrow passages that connect the ovaries to the uterus. A healthy fallopian tube is around 10-13 cm long and has a curly shape.
The fallopian tubes have small hair-like structures called cilia, which contract and relax. They help sweep the egg released during ovulation from the ovary toward the uterus. These muscles also help facilitate the movement of the egg and sperm toward each other so they can meet. At the same time, the tubes secrete nutrients that help to nourish the egg and sperm. Once they meet, the sperm can fertilize the egg, creating an embryo.
After fertilization, the fertilized egg (embryo) continues to the uterus, where it can implant, grow and develop into a baby.
What are Blocked Fallopian Tubes?
According to a study, tubal factor infertility (TFI) accounts for 25 – 40 % of all infertility cases. TFI is caused by blockage or damage to the fallopian tubes.
Fallopian tubes are critical for conception; any blockage due to injury or other issues can lower your chances of getting pregnant. The blockage can be partial, affect one side, or be complete, blocking both tubes.
When the opening of a fallopian tube is entirely closed or partially obstructed, the tube is considered blocked. The extent of the blockage can make it challenging or even impossible to conceive without intervention.
When the fallopian tubes are completely blocked, the egg and sperm cannot meet, which prevents fertilization.
In the case of partially blocked tubes, if fertilization does happen, a blockage could prevent the embryo from reaching the uterus, where it typically implants and grows. This increases the risk of an ectopic pregnancy, where the fertilized egg implants outside the uterus, usually in the fallopian tubes. Ectopic pregnancies are not sustainable and can lead to serious medical problems.
What Causes Damaged or Blocked Tubes?
The fallopian tubes, being small in size, can easily get damaged or blocked. The most common reason for this is scarring on the tube walls, which is caused by infection. Infection can occur due to various reasons.
The following are the most frequent causes of blockage in the tubes.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an infection that can impact the female reproductive organs, including the ovaries, fallopian tubes, cervix, and uterus. It is a complication often caused by sexually transmitted diseases. However, other infections can also result in PID.
Fibroids
Fibroids, benign uterus tumors, affect a significant proportion of women of reproductive age.
In some ethnicities and women nearing age 50, this likelihood can increase to 70-80%. Fibroids can change the shape or size of the uterus, and sometimes even the cervix. They can also grow in different locations within and around the uterus.
Fibroid growths do not directly cause blocked fallopian tubes but can affect the diameter of these delicate passages. If a fibroid grows near or in a way that compresses a fallopian tube, it could impact the diameter of the tube.
Endometriosis
Endometriosis is a medical condition where the layer of tissue that typically lines the uterus, known as the endometrium, grows in other parts of body. Endometriosis most commonly occurs on the fallopian tubes or the ovaries. This condition can obstruct the tubes, making it difficult to conceive. It also increases the risk of ectopic pregnancy.
Hydrosalpinx
A hydrosalpinx is a condition where fluid accumulates and blocks the tubes, making it challenging to conceive. An untreated infection usually causes the condition. Treatment options for a hydrosalpinx may involve draining and repairing the tubes or, in some cases, removing them through a procedure known as salpingectomy.
Scar Tissue or Pelvic Adhesions
Pelvic adhesions refer to a condition where scar tissue or adhesions bind organs together near the pelvic region, often affecting the fallopian tubes, uterus, ovaries, and bladder.
Inflammation or infection in the pelvic area is the primary cause of adhesions, with previous pelvic surgeries being a common cause of tissue scarring.
Scar tissue from adhesions can cause pelvic pain and infertility, but surgical intervention can improve fertility. However, diagnosing and treating adhesions can be challenging.
Congenital Abnormalities
A congenital tubal blockage is a defect or abnormality in the development of the fallopian tubes from birth.
Congenital tubal blockage can affect one or both of the fallopian tubes. It is often diagnosed through imaging tests such as hysterosalpingography (HSG) or laparoscopy. Treatment options for congenital tubal blockage depend on the severity of the blockage and may include surgery or assisted reproductive technologies such as in vitro fertilization (IVF).
Pelvic or Abdominal Surgeries
Surgery around the pelvic or abdominal area can cause blocked fallopian tubes due to the formation of scar tissue, also known as adhesions, in and around the tubes.
The formation of adhesions is a normal part of the healing process after surgery. However, in some cases, the adhesions can attach to the fallopian tubes, causing them to become twisted, kinked, or blocked. This can prevent the eggs from reaching the uterus and interfere with fertilization.
The risk of developing tubal adhesions after surgery depends on several factors, including the type and extent of the surgery, the surgeon’s skill, the presence of infection, and the woman’s healing response.
Some pelvic or abdominal surgeries that can increase the risk of tubal adhesions include surgeries for endometriosis, ovarian cysts, fibroids, or ectopic pregnancy, as well as surgeries to remove the uterus or ovaries.
Miscarriages
Miscarriages typically do not cause blocked tubes. However, in rare cases, a miscarriage may be complicated by an infection that can lead to scarring and blockage of the tubes.
In addition, some medical procedures used to manage a miscarriage, such as dilation and curettage (D&C), can increase the risk of developing scar tissue in the uterus or fallopian tubes.
However, the risk of developing tubal blockage after a miscarriage is generally low, and most women who have a miscarriage do not experience any long-term complications that affect their fertility.
STD Infections
STD infections can cause inflammation and scarring in the tubes.
Common STDs that can cause tubal blockage include chlamydia and gonorrhea. Prompt treatment of STDs can help reduce the risk of tubal damage and infertility.
Uterine Infections
Uterine infections can spread from the uterus to the fallopian tubes, causing a condition called salpingitis, which is inflammation of the tubes. Salpingitis can damage the tubes’ delicate lining and lead to scar tissue formation, which can obstruct the movement of eggs and sperm. This can increase the risk of infertility and ectopic pregnancy.
Some common causes of uterine infections include bacterial vaginosis, pelvic inflammatory disease (PID), and sexually transmitted infections (STIs) such as chlamydia and gonorrhea. Early treatment of uterine infections can help prevent the development of tubal damage or blockage.
What are the Symptoms of Blocked Fallopian Tubes?
Blocked fallopian tubes often do not cause any noticeable symptoms. However, some women may experience abdominal or pelvic pain, unusual vaginal discharge, painful periods, or irregular menstrual cycles.
In some cases, infertility or recurrent miscarriages may be the only indication of tubal blockage. If you are experiencing any of these symptoms, it is essential to consult with a doctor to determine the underlying cause and receive appropriate treatment.
Can You Get Pregnant with One Blocked Fallopian Tube?
Yes, getting pregnant with one blocked fallopian tube is possible, but the chances of conception may be reduced.
Women with a blockage in one tube typically have a lesser chance of getting pregnant than those with both tubes unblocked. A study showed that in 38 women with this type of blockage, only about one-third (13 women or 34.2%) became pregnant within a year after the blockage was cleared. This implies that having a single blocked fallopian tube can decrease conceiving odds.
However, the odds may depend on the location and severity of the blockage and other factors such as age and other fertility issues. For example, if the blocked tube is closer to the ovary, the chances of pregnancy may be higher, as the egg can still be picked up by the open tube.
In addition, some studies have suggested that fertility treatments such as IVF may effectively overcome unilateral tubal blockage and achieve pregnancy. IVF bypasses the fallopian tubes by retrieving eggs directly from the ovaries, fertilizing them in a lab, and then transferring the resulting embryo(s) into the uterus.
7 Steps to Getting Pregnant with Blocked Fallopian Tubes
If you have been diagnosed with fallopian tube blockage, there are still ways you can get pregnant with blocked fallopian tubes. Here, we have outlined seven simple steps that can help you conceive.
Step 1 – Understand the Importance of Fallopian Tubes in Pregnancy
The fallopian tubes play a significant role in achieving pregnancy.
The finger-like projections (fimbriae) located at the end of the tube are responsible for collecting the egg released from the ovary. Once the egg is collected, the fallopian tube protects it until the sperm fertilizes it. The tube then nurtures the embryo as it travels through the tube before reaching the uterus.
For this process to work correctly, the tubes must be open, and the inside lining must act as a conveyor system, transporting the developing embryo to the uterus.
However, if the fallopian tubes are damaged or blocked, the egg and sperm cannot interact, and the proper movement of embryos to the uterus cannot happen.
Step 2 – Recognize the Signs and Symptoms of Damaged or Blocked Fallopian Tubes
Many women may have blocked fallopian tubes without knowing it until they try to conceive and face difficulties.
One of the symptoms of a blocked tube is mild, consistent pain on one side of the abdomen. This occurs because the blocked tube fills up with fluid and expands. Conditions like endometriosis, for instance, can cause pelvic pain and heavy periods, which might increase the risk of blocked tubes.
Identifying the cause of blockage or damage in the tubes is important before seeking treatment.
Step 3 – Track the Steps You Take to Get Pregnant
There are several steps couples can take to track their progress in getting pregnant.
- Keep track of menstrual cycle: Couples should keep track of the female partner’s menstrual cycle. They should note the first day of the menstrual period, the last day, and the cycle length.
- Use ovulation prediction tools: Couples can use tools such as ovulation predictor kits, fertility monitors, or apps that track ovulation to help them determine the most fertile days in the cycle.
- Have regular intercourse: Couples should try to have regular intercourse during the most fertile menstrual cycle days. This is typically around the time of ovulation.
- Maintain a healthy lifestyle: Both partners should maintain a healthy lifestyle by eating a balanced diet, exercising regularly, managing stress, and avoiding alcohol, smoking, and drugs.
- Stay positive: Trying to conceive can be stressful, but couples need to stay positive and be supportive of each other. Stress can negatively impact fertility, so finding ways to relax and reduce stress can be helpful.
- Seek medical advice: If a couple has been trying to conceive for a year or more without success, they should seek medical advice. A fertility specialist can help identify any underlying causes of infertility and recommend appropriate treatment options.
Step 4 – Make an Appointment with a Fertility Specialist
If you are having trouble conceiving, you must talk with your doctor about your options. While several factors can contribute to infertility, your fallopian tubes may be the culprit.
It is important to note that most women do not experience symptoms of blocked tubes, and the only way to diagnose the problem is to start the diagnostic process. You can bring this up during a routine checkup with your OB-GYN, but if you do not want to wait until your next scheduled visit, you should request an appointment sooner to have your tubes checked.
A fertility expert will discuss your medical history, answer your questions, perform tests, diagnose, and suggest the best treatment option suited to your needs.
Step 5 – Know the Severity of the Blockage of Fallopian Tubes
Several minimally invasive procedures can determine the extent, if any, of fallopian tube blockages with minimal recovery time. These procedures include hysterosonography (HSN), hysterosalpingograms (HSG), and laparoscopy with chromotubation.
Hysterosonograms (HSN)
An HSN is a high-resolution ultrasound that can check for blocked fallopian tubes. During the procedure, a small amount of saline solution is injected through the cervix into the uterus, which helps to expand the cavity and provide better visibility.
The saline solution can also help to show whether the tubes are open or blocked. The tubes are open if the solution can pass through them and spill into the abdominal cavity. If the solution cannot pass through the tubes, it may indicate a blockage.
It’s important to note that an HSN cannot always definitively diagnose a blocked tube, and additional testing may be required for a more accurate diagnosis.
Hysterosalpingogram (HSG)
Hysterosalpingogram (HSG) is an extensive diagnostic test that provides detailed information about the fallopian tubes.
During the procedure, a special dye is injected into the cervix and flows through the uterus and into the tubes. As the dye moves through the tubes, X-ray images are taken to detect any blockages or abnormalities. If the dye cannot flow freely through the tubes, it indicates that they are blocked.
The HSG test is usually done in the first half of the menstrual cycle after menstruation has ended but before ovulation occurs, to reduce the risk of interfering with a potential pregnancy.
The procedure takes less than 10 minutes, and patients can return home shortly after. However, it can cause cramping and may require further evaluation if the tubes require closer examination.
Laparoscopy with Chromotubation
Laparoscopy with chromotubation is a complex surgical procedure that requires hospitalization and general anesthesia.
The patient will undergo two small incisions – one for the laparoscope to enter the abdomen and another for a probe to obstruct the view of the reproductive organs.
Once the instruments are in place, a dye test called chromotubation will be performed, which involves injecting the dye through the cervix and into the uterus, which flows through the fallopian tubes. The dye makes it possible to see any blockages or abnormalities in the tubes on a monitor.
If any blockages or abnormalities are detected, the surgeon may attempt to correct them during the same procedure. After the procedure, patients may experience some cramping and discomfort but can typically return to normal activities within a few days.
Laparoscopy with chromotubation is typically reserved for cases where other diagnostic tests have been inconclusive, or surgery is needed to correct the problem.
Step 6 – Understand your Diagnosis
Understanding your diagnosis is crucial when it comes to fertility. Consult with your doctor to discuss the consequences of your diagnosis and explore your options.
While some cases of blocked or damaged tubes may only cause a delay in conception, others may require more advanced treatment.
Treatment options will depend on the severity and position of the damage or blockage, as determined by the tests.
Step 7 – Explore Treatment Options
If your doctor detects a blockage in the fallopian tubes, these obstructions can be removed through various medical and surgical procedures. The treatment approach depends on the location and extent of the blockage and the underlying cause.
Laparoscopic Surgery
In this procedure, the patient is placed under general anesthesia. The surgeon makes a small incision near the navel and inserts a laparoscope, a thin, flexible tube with a camera and light at the end.
The surgeon can then monitor the fallopian tubes and surrounding tissues. Small instruments are inserted through other small incisions to remove adhesions or blockages in the fallopian tubes.
The procedure typically takes 30 minutes to an hour and has a low risk of complications.
Hysteroscopic Tubal Cannulation
This procedure removes blockages in the narrowest part of the fallopian tubes, called the isthmus. The patient may be given a local anesthetic or mild sedation.
A hysteroscope, a thin, flexible tube with a camera and light at the end, is inserted through the cervix and guided into the uterus. A small catheter is inserted through the hysteroscope and guided into the fallopian tubes.
The blockage can be cleared using a small balloon or a tiny instrument, such as a laser, that can remove the blockage and improve the openness of the tube. This procedure is typically done on an outpatient basis and has a low risk of complications.
Hysteroscopic tubal cannulation is a safe and effective treatment for blockages in the tubes caused by adhesions, scar tissue, or other factors. It may be used as a first-line treatment for women with blockages or as a complementary procedure to other fertility treatments, such as in vitro fertilization (IVF).
Salpingectomy
Sometimes, the blocked portion of the fallopian tube may need to be removed entirely. This is called a salpingectomy or blocked fallopian tube surgery.
The patient is placed under general anesthesia, and the surgeon makes a small incision in the abdomen. The affected portion of the fallopian tube is then removed. In some cases, the surgeon may be able to perform a salpingostomy instead, which involves making a small incision in the blocked part of the tube to create a new opening.
This procedure is typically done on an outpatient basis and has a low risk of complications.
Intrauterine Insemination (IUI)
IUI is a fertility treatment in which sperm is placed directly into a woman’s uterus at ovulation. IUI aims to increase the chances of fertilization by providing the sperm with a head start and bringing them closer to the egg.
The process of IUI involves several steps:
1. Ovulation induction: The woman may be given medications to stimulate ovulation and increase the chances of producing multiple eggs.
2. Sperm preparation: The male partner or donor provides a semen sample, which is washed and concentrated to remove dead or immotile sperm and other impurities.
3. Insemination: The prepared sperm is placed into the woman’s uterus using a thin, flexible catheter inserted through the cervix. The procedure is typically done in the doctor’s office and takes only a few minutes.
After the procedure, the woman may be advised to lie down briefly to increase the chances of successful fertilization. A pregnancy test can be taken about two weeks after the IUI to determine if the procedure was successful.
In Vitro Fertilization (IVF)
IVF may be a viable option if the fallopian tubes cannot be unblocked. In this procedure, the patient undergoes a series of hormonal treatments to stimulate the ovaries to produce multiple eggs.
The eggs are then retrieved from the ovaries and fertilized with sperm in a laboratory dish. The resulting embryos are cultured for several days, and one or more are implanted in the uterus.
IVF success rates vary depending on the patient’s age and the underlying cause of infertility, but it is generally a safe and effective option.
Natural Remedies
While medical treatments such as surgery, medications, and assisted reproductive technologies may be the most effective ways to treat blocked fallopian tubes, there are also some natural and alternative therapies that some women have tried to improve their chances of conceiving.
It’s important to note that there is limited scientific evidence to support the effectiveness of these therapies. These options may not be appropriate for everyone and should not be used as a substitute for medical treatment. It’s always best to consult a healthcare provider before trying new treatments.
Some natural and alternative therapies that have been suggested for treating blocked fallopian tubes, include:
Acupuncture
Acupuncture may help improve fertility by increasing blood flow to the reproductive system and organs, reducing stress, and regulating hormones. The insertion of thin needles into specific points on the body is believed to balance energy flow, which can lead to improved fertility.
Herbal Supplements
Some herbal supplements, such as chasteberry, red clover, and dong quai, have been suggested to improve fertility by regulating hormones, increasing blood flow to the reproductive organs, and reducing inflammation. However, there is limited scientific evidence to support the effectiveness of these supplements, and some may even have harmful side effects.
Yoga and Meditation
Practicing yoga and meditation may help to reduce stress and promote relaxation, which can, in turn, help to improve fertility by regulating hormones and increasing blood flow to the reproductive organs.
Diet and Lifestyle Changes
Eating a healthy diet, maintaining a healthy weight, and avoiding alcohol and smoking may help to improve fertility by reducing inflammation, regulating hormones, and improving overall health.
It’s important to note that each procedure has risks and benefits, and the best option for a particular patient depends on their circumstances and medical history. A fertility specialist can provide more detailed information and help the patient make an informed decision.
Frequently Asked Questions (FAQs)
Q1: Can I naturally get pregnant with blocked fallopian tubes?
Pregnancy is possible if at least one of the fallopian tubes is open, but natural conception is not possible if both tubes are blocked.
Q2: What will happen if the fallopian tube is blocked?
If a fallopian tube is blocked, it can prevent egg fertilization by sperm, leading to difficulty in getting pregnant naturally. In some cases, it can also increase the risk of ectopic pregnancy.
Q3: Where does the egg go if fallopian tubes are blocked?
If the fallopian tubes are completely blocked, the egg released from the ovary cannot reach the uterus, and it may either remain in the fallopian tube, get reabsorbed by the body or form a tubal pregnancy if it is fertilized.
Q4: What is Endometriosis?
Endometriosis is a condition in which the tissue that normally lines the inner walls of the uterus grows in other areas outside of the uterus, like on the ovaries, fallopian tubes, or other organs in the pelvic region. This tissue can cause inflammation, scarring, and pain and affect fertility.
Q5: Is it possible to conceive after tubal surgery?
Your chances of getting pregnant after tubal surgery depends on how severe the damage is, where in the fallopian tubes the surgery is done, and what kind of surgery you have. The chance of getting pregnant after the surgery is low, between 1% and 3.7%, depending on your age and the type of surgery. Even if you get pregnant after your tubes are tied, there is a higher risk of an ectopic pregnancy.
Q6: Is pregnancy possible with one blocked uterine tube?
Yes, pregnancy is still possible with one blocked uterine tube, although it may reduce the chances of conception.
Q7: Can I still have a healthy pregnancy if one or both of my fallopian tubes are obstructed?
Even if only one fallopian tube is blocked, a healthy pregnancy is still possible since there are two ovaries. However, natural conception is impossible if both tubes are blocked unless one or both tubes are opened.
Q8: How can I tell whether one or both of my fallopian tubes are blocked?
Laparoscopy or a hysterosalpingogram (HSG) are the two main procedures to determine if one or both fallopian tubes are blocked.
Q9: Can I take any medications to help me become pregnant with blocked fallopian tubes?
There are no medications that can clear blocked fallopian tubes; surgery may be necessary to improve the chances of pregnancy. However, fertility medications can help stimulate ovulation, increasing the chances of getting pregnant via in vitro fertilization (IVF) or intrauterine insemination (IUI).
Q10: How long does it take to conceive when the fallopian tubes are blocked?
There is no specific time frame for conception with blocked fallopian tubes, as it depends on various factors such as the severity of the fallopian tube blockage, age, and other fertility factors.
Q11: What risks are associated with getting pregnant with blocked fallopian tubes?
The main risk associated with getting pregnant with blocked fallopian tubes is the increased likelihood of ectopic pregnancy, which occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube. This can be a medical emergency and can lead to severe complications if not detected and treated promptly. Additionally, women with blocked fallopian tubes may have an increased risk of miscarriage and other pregnancy complications.
Q12: Are there any lifestyle changes that can help me get pregnant with blocked fallopian tubes?
Making specific lifestyle changes such as maintaining a healthy weight, quitting smoking, reducing alcohol consumption, managing stress, and eating a well-balanced diet with plenty of fruits, vegetables, and whole grains can increase the chances of getting pregnant. Regular exercise and taking fertility supplements, such as folic acid and omega-3 fatty acids, may also be beneficial. However, it’s important to remember that lifestyle changes alone may not be enough to overcome tubal blockages, and medical treatment may still be necessary.
Q13: How important is it to seek medical advice from a fertility specialist for blocked fallopian tubes?
It is essential to seek medical advice from a fertility specialist for blocked tubes to determine the best treatment options and increase the chances of a successful pregnancy.
Q14: What is the best way to get pregnant with a blocked fallopian tube?
The best way to get pregnant with a blocked fallopian tube is through assisted reproductive technologies such as in vitro fertilization (IVF) or intrauterine insemination (IUI). According to a study published in the Journal of Assisted Reproduction and Genetics, IVF is the most effective method for achieving pregnancy in women with tubal factor infertility due to blocked tubes. However, consulting with a fertility specialist or reproductive endocrinologist is vital to determine your situation’s best course of action.
Q15: Do you ovulate with blocked fallopian tubes?
Yes, ovulation can still occur with blocked fallopian tubes, but the egg cannot travel down the tube and fertilize naturally.
Q16: How do you clear blocked fallopian tubes?
Several medical treatments can clear blocked fallopian tubes, such as laparoscopic surgery, hysteroscopic tubal cannulation, or in vitro fertilization (IVF). However, the success rate of these treatments may vary depending on the underlying cause and severity of the blockage. You can also try natural and alternative methods to increase your chances of conception, like herbal supplements and acupuncture.
Q17: How can I unblock my fallopian tubes without surgery?
Unfortunately, there is no proven way to unblock fallopian tubes without surgery. While some natural remedies and alternative therapies are promoted for this purpose, limited scientific evidence supports their effectiveness. Therefore, surgical intervention remains the most reliable option for unblocking fallopian tubes.
Q18: Can HSG open blocked tubes?
Hysterosalpingography (HSG) is primarily a diagnostic procedure. While HSG may help to clear minor blockages in the tubes, the success rate of this technique is limited.
Q19: Can a sperm meet an egg if the fallopian tube is blocked?
If both fallopian tubes are blocked, it is unlikely that sperm will be able to meet the egg. However, if only one tube is blocked, there is still a chance that fertilization can occur if the egg is released from the ovary on the side of the unblocked tube.
Q20: Do periods stop if fallopian tubes are blocked?
Blocked fallopian tubes do not usually affect the menstrual cycle, and periods are likely to continue normally.
Takeaway
While blocked fallopian tubes can pose a challenge for conception, some steps can be taken to increase the chances of pregnancy. By seeking medical advice, undergoing fertility treatments, maintaining a healthy lifestyle, and addressing any underlying conditions, couples can overcome this obstacle and start their journey toward parenthood. Your dream of having a baby can become a reality with patience, persistence, and support.
References
Obrzut, B., & Obrzut, M. (2022). Is There Still a Place for Reconstructive Surgery in Distal Tubal Disease? Journal of Clinical Medicine, 11(12), 3278. https://doi.org/10.3390/jcm11123278Jennings LK, Krywko DM. Pelvic Inflammatory Disease. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499959/Guo, X. C., & Segars, J. H. (2012). The Impact and Management of Fibroids for Fertility: An evidence-based approach. Obstetrics and gynecology clinics of North America, 39(4), 521. https://doi.org/10.1016/j.ogc.2012.09.005Ectopic Pregnancy Trust. (n.d.). Endometriosis and Ectopic Pregnancy. Retrieved July 29, 2023, from https://www.ectopicpregnancy.co.uk/endometriosis-and-ectopic-pregnancy/Palagiano, A., Cozzolino, M., Ubaldi, F. M., Palagiano, C., & Coccia, M. E. (2021). Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization. RBGO Gynecology & Obstetrics, 43(4), 304-310. https://doi.org/10.1055/s-0040-1722155Mount Sinai. (n.d.). Adhesion. Retrieved July 24, 2023, from https://www.mountsinai.org/health-library/diseases-conditions/adhesionBugg, C. W., & Taira, T. (2016). Pelvic Inflammatory Disease: Diagnosis And Treatment In The Emergency Department. Emergency medicine practice, 18(12), 1–24.Workowski, K. A., Bolan, G. A., & Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 64(RR-03), 1–137.Fataftah, J., Tayyem, R., & Al Rshoud, F. (2022). Spontaneous pregnancy rate after fallopian tube recanalization for unilateral obstruction with a patent contralateral tube. Egyptian Journal of Radiology and Nuclear Medicine, 53(1), 1-7. https://doi.org/10.1186/s43055-022-00916-8Mayer C, Deedwania P. Hysterosalpingogram. [Updated 2022 Sep 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572146/Progyny. (n.d.). Saline sonogram, hysterosalpingogram, sonohysterosalpingogram. Retrieved July 24, 2023, from https://progyny.com/education/fertility-testing/saline-sonogram-hysterosalpingogram-sonohysterosalpingogram/Mann, C., Karl, K., Ertl-Wagner, B., Weigand, H., & Thaler, C. J. (2016). Laparoscopic Chromopertubation, Myomectomy with Opening of the Uterine Cavity and Hysteroscopy during the Early Implantation Phase of an Undetected Pregnancy: Delivery of a Child with a Complex Brain Malformation. Geburtshilfe und Frauenheilkunde, 76(8), 906-909. https://doi.org/10.1055/s-0042-106086Keltz, M., Brown, E. C., Frishman, G. N., & Sauerbrun-Cutler, T. (2022). Fluoroscopically-Guided Hysteroscopic Tubal Cannulation: A Procedure for Proximal Tubal Obstruction. JSLS: Journal of the Society of Laparoscopic & Robotic Surgeons, 26(4). https://doi.org/10.4293/JSLS.2022.00047Allahbadia, G. N. (2017). Intrauterine Insemination: Fundamentals Revisited. Journal of Obstetrics and Gynaecology of India, 67(6), 385-392. https://doi.org/10.1007/s13224-017-1060-xDate, S. V., Rokade, J., Mule, V., & Dandapannavar, S. (2014). Female sterilization failure: Review over a decade and its clinicopathological correlation. International Journal of Applied and Basic Medical Research, 4(2), 81-85. https://doi.org/10.4103/2229-516X.136781Jain M, Singh M. Assisted Reproductive Technology (ART) Techniques. [Updated 2022 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576409/