Treatment of tubal blockage

Tubal factors contribute to 20% to 35% of female infertility cases and commonly result from obstruction or dysfunction of the fallopian tubes due to pelvic inflammatory disease (PID), endometriosis, or previous pelvic surgery (1).

Tubal surgery should be considered as a treatment option for mild tubal disease (2).

Fallopian tube catheterisation by hysteroscopic or radiological guidance should be considered to treat subfertility due to proximal tube obstruction, after discussing the risks and benefits of other options, including in vitro fertilisation (IVF) (2):

• the NICE committee note “…In practice, IVF is often offered to those with proximal tubal obstruction. However, for some people, tubal catheterisation may be the preferred treatment option, particularly where there might be religious or other objections to IVF, or where IVF might not be expected to have a significantly higher success rate relative to spontaneous conception – as in the case of those with diminished ovarian reserve..”

Surgery for hydrosalpinges before IVF (2)

• laparoscopic salpingectomy or tubal occlusion to should be offered treat hydrosalpinges before IVF
• consider aspiration to treat hydrosalpinges, close to the time of oocyte retrieval, if there is a high risk of complications from laparoscopic surgery

Reference

1. Adebisi OY, Singh M, Tobler KJ. Female Infertility. [Updated 2025 Nov 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.
2. NICE. Fertility problems: assessment and treatment. Clinical guideline CG156. Published February 2013, last updated March 2026