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Causes and Treatment of Tubal Factor Infertility

April 17, 2013

Women who are having trouble trying to conceive may be surprised to find that tubal factor infertility is the reason for not getting pregnant. The fallopian tubes allow an egg to travel from the ovaries to the uterus. The fimbriated ends of the tubes grab hold of the egg and cilia help to pass the egg down to the uterus. Fertilization occurs in the fallopian tubes, so sperm must be able to enter the fallopian tubes. A blockage or structural damage to the fallopian tubes could significantly impact each of these processes and could also increase a woman’s risk of ectopic pregnancy.

Sandy Goodman, M.D. of The Reproductive Medicine Group in Tampa, Florida says there are several causes of tubal blockage and structural damage to the fallopian tubes including:

  • Pelvic or fallopian tube infection
  • Scar tissue resulting from pelvic or tubal surgery
  • Endometriosis

“Pelvic infections such as gonorrhea or chlamydia can damage both the cilia and the fimbria affecting transport of the embryo which also can increase the chances of having an ectopic pregnancy or cause tubal blockage. Previous surgery within the pelvis can result in scar tissue formation that can involve the fallopian tubes affecting the ability of the tube to pick up the egg. Endometriosis, often associated with painful menstrual cycles and infertility, can also cause scar tissue that can involve the fallopian tubes. Some of these conditions can damage the tube at the fimbriated ends while others may cause blockage where the tube enters the uterus,” she explains.

Women who have contracted a sexually transmitted disease (STD) like gonorrhea or chlamydia, or developed a pelvic infection like pelvic inflammatory disease (PID) -which can result from an untreated STD- have a greater risk of experiencing tubal factor infertility. Women who have had prior pelvic surgeries, tubal surgeries, a history of ectopic pregnancy, or history of endometriosis are also more likely have tubal blockage or structural anomalies.

Fortunately, there are treatment options for either clearing fallopian tube blockages or helping a woman to conceive by bypassing the tubes. Dr. Goodman advises: “Tubal factor infertility may be addressed by surgery, depending on the extent of damage to the tubes, or by In Vitro Fertilization (IVF). Significantly damaged fallopian tubes are not amenable to surgical correction and may need to be ligated or removed prior to IVF.” If a fertility doctor believes that fallopian tube complications could interfere with a pregnancy, cause an ectopic pregnancy, or infection could spread, they may recommend removal of the fallopian tubes prior to beginning an IVF cycle.

Women should be proactive about screening and treating STDs to prevent pelvic infection which can lead to tubal infertility. Also, early diagnosis and treatment of an ectopic pregnancy can reduce the risk of fallopian tube damage and management of endometriosis scar tissue growth can also reduce the risk of tubal factor infertility.

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