Tubal Infertility

The fallopian tubes are critical for natural pregnancy to occur; normally, your fallopian tubes pick up ovulated eggs, and provide the location for where the sperm and egg first meet, and where the egg is fertilized.  Damage to or abnormalities within the tubes can lead to tubal dysfunction, and approximately 20% of female infertility can be attributed to tubal causes.

Following a detailed clinical history and tubal evaluation by your Team RMI physician, a tubal factor may be identified


Common Causes of Tubal Factor Infertility

Pelvic Inflammatory Disease


 


One of the most common causes of tubal infertility results from a prior history of pelvic inflammatory disease (PID), which is an infection in the female reproductive system, and can often involve the uterus, fallopian tubes, and occasionally the ovaries.  PID can be caused by a previous history of sexually transmitted infections, such as Neisseris Gonorrhoeae or Chlamydia trachomitis, however in many cases there may be multiple different bacteria involved. 

PID can lead to scarring of the tubes, and can not only cause tubal factor infertility, but can also lead to chronic pelvic pain and increase future risk for ectopic pregnancy (non viable pregnancies located outside of the uterus).  The rate of tubal infertility has been reported to be 12% after one, 23% after two, and 53% after three episodes of PID. 
 

Hydrosalpinx


 


Like any tubal structure in your body, your fallopian tubes make mucous.  If there is damage and blockage of the end portion of the fallopian tube, the tube fills with mucous and appears fluid filled.  Causes of hydrosalpinx may include previous pelvic infection, scar tissue, or endometriosis, and in most cases women are asymptomatic (with the exception of infertility).  The presence of hydrosalpinx may increase the risk for chemical and ectopic pregnancy (pregnancy located outside of the uterus) and may also reduce the chance for success with in vitro fertilization. 
 
On HSG, Hydrosalpingses have characteristic appearances; In less severe forms, the fimbriae may be damaged, but some patency may still be preserved. 

For more information on Hydrosalpinx:

http://www.reproductivefacts.org/topics/topics-index/hydrosalpinx/


Extrapelvic Causes

Other causes of tubal factor infertility can include severe pelvic adhesions, endometriosis, previous pelvic surgery (especially if performed on the tube), and previous pelvic infection (from an appendicitis or after a previous delivery).

The formation of adhesions may not necessarily block a fallopian tube, but may render it dysfunctional by distorting or separating it from the ovary.
 
Treatment of Tubal Factor Infertility

If a tubal factor for infertility is identified, your Team RMI physician will discuss with you the best next option for fertility treatment.  Generally, tubal factor infertility can be treated by surgery, in vitro fertilization, or a combination of the two.

 

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