For natural conception to occur, at least one fallopian tube must be open. If both tubes are blocked or severely damaged, the sperm and egg cannot meet, leading to infertility.  

There are two main types of tubal obstructions:  

- Proximal blockages, which occur near the uterus and are sometimes treatable with non-surgical catheterization.  

- Distal blockages, which happen closer to the ovaries and often result in hydrosalpinx, a condition where fluid accumulates in the blocked tube.  

Why Should Distal Blockages and Hydrosalpinx Be Treated?  

Beyond preventing fertilization, hydrosalpinx can negatively impact embryo implantation. The fluid trapped inside the blocked tube can flow back into the uterus, creating an inflammatory environment that may lead to implantation failure or miscarriage, even in women undergoing assisted reproductive treatments like IVF.  

Surgical treatment can involve either:  

- Attempting to restore tubal function (neosalpingostomy) if the tube appears healthy.  

- Removing the damaged tube if its condition could reduce fertility success rates.  

Is It Possible to Repair a Blocked Tube?  

Distal blockages can sometimes be surgically repaired, but the success depends on the condition of the tube. Even after surgery, there is a high risk of re-blockage within a year. If the damage is too severe, removing the tube is often the better option, especially for women pursuing IVF.  

For proximal blockages, a technique called selective tubal catheterization may be attempted during an hysterosalpingography (HSG). This involves passing a tiny catheter through the uterus into the tube to clear the obstruction, with a success rate of around 60%.