Tubal Infertility

 Approximately 20% of female infertility can be attributed to tubal causes.

One of the most common causes of tubal infertility results from a prior history of pelvic inflammatory disease (PID).  The rate of tubal infertility has been reported to be 12% after one, 23% after two, and 53% after three episodes of PID.  
 
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).
An example of tubal pathology that may be identified at the time of either hysterosalpingogram (HSG) or Laparoscopy  is a Hydrosalpinx.    
 
Hydrosalpingses have characteristic appearances; In less severe forms, the fimbriae may be damaged, but some patency may still be preserved.  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. 
 
Fallopian tubes may also be occluded or disabled by endometriosis, infections after childbirth, appendicitis and peritonitis. The formation of adhesions may not necessarily block a fallopian tube, but may render it dysfunctional by distorting or separating it from the ovary.
 
Tubal factor infertility is usually treated by surgery, in vitro fertilization, or a combination of the two 
 

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