Tubal factor infertility occurs when the fallopian tubes are blocked, scarred or damaged, preventing the egg from entering the uterus.
Each month, during ovulation, the ovaries release an egg that is picked up by the fallopian tubes. If the egg comes into contact with sperm while in the fallopian tube, fertilization may occur. The fertilized egg begins dividing then travels through the fallopian tube and into the uterus where implantation occurs.
Women with tubal factor infertility have fallopian tube damage that prevents this process from occurring normally. Damage to the end of the fallopian tube (distal tube damage) can prevents the tube from picking up the egg. Blockage in the portion of the tube closest to the uterus is referred to as proximal tube damage.
Infections, previous pelvic surgery, endometriosis, STDs (including chlamydia or gonorrhea) and a previously ruptured appendix can all result in scarring or damage of the tubes and lead to tubal factor infertility. Rarely, a woman is born with no fallopian tube or only one.
When the distal end of the fallopian tube is blocked, fluid can accumulate causing the tube to swell. This fluid-filled tube is known as a hydrosalpinx. This condition can dramatically reduce the chance of a successful pregnancy.
Since most women with tubal factor infertility do not experience symptoms, fertility specialists often recommend hysterosalpingogram (HSG) as part of the early infertility evaluation.
Hysterosalpingogram is an x-ray of the uterus and fallopian tubes that utilizes a special dye, which is injected into the uterus. This allows your fertility specialist to track the dye to ensure it moves freely through the tubes and into the pelvic cavity. It is important to note that even when the dye passes through, damage may still be present inside the tube.
Laparoscopy may also be done to examine the outside condition of the tubes. The procedure is performed under general anesthesia using a lighted scope that is inserted into the abdomen through a small incision. Additional incisions may be done to accommodate other surgical instruments.
This diagnostic procedure is performed to assess the condition of the tubes, ovaries and uterus and to look for blockage or scarring on the outside of the tubes. If observed, the damaged tissue may be removed during the laparoscopy.
In cases where blockage or scarring is discovered, surgery may be recommended to correct the problem. However, surgery will not improve the function of the tubes.
When the tubes are severely damaged or a hydrosalpinx is present, your fertility specialist may recommend removing the tubes before undergoing in vitro fertilization, since leaving damaged tubes in place can reduce IVF success rates.
