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BLOCKED FALLOPIAN TUBES AND TUBAL FACTOR INFERTILITY

The fallopian tubes must be open and undamaged to allow the sperm to fertilize an egg and the resulting embryo to be transported to the uterus for pregnancy.
Tubal factor infertility is the result of scarring, blockage or dilation (hydrosalpix) of the fallopian tube, which can be caused by pelvic surgery, endometriosis or pelvic infections, in particular, pelvic inflammatory disease (PID).
Tubal damage is associated with an increased risk of tubal, or ectopic pregnancy.

WHAT IS TUBAL FACTOR INFERTILITY?

The two fallopian tubes are delicate structures that allow for transit between the uterus and the ovary. The fallopian tube allows the sperm to swim from the uterus toward the egg, while the distal end of the fallopian tube (the fimbria) picks up the ovulated egg. Fertilization can then occur in the fallopian tube, which uses its cilia (tiny hair like structures) to sweep the resulting embryo to the uterus.

At least one tube must be clear to allow the sperm to fertilize an egg and the resulting embryo to be transported to the uterus. If the fallopian tube is blocked, scarred or distorted, the egg and sperm cannot combine. Additionally, a partially blocked or damaged fallopian tube may allow the sperm to reach the egg for fertilization but not be able to transport the resulting embryo to the uterus. This can result in an ectopic, or tubal pregnancy, which can be life threatening.

25 to 35 percent of female infertility cases are caused by problems with the fallopian tubes. Tubal damage is particularly suspect in women with regular, ovulatory menstrual cycles and a partner with normal sperm.

A TUBAL BLOCKAGE IS TYPICALLY CATEGORIZED BY ITS LOCATION.

Proximal tubal blockage: Located close to the uterus. This can be the result of tubal spasm or a mucous plug. However, it may be due to complete scarring to the proximal tube.
Mid-segment tubal blockage: When the middle of the fallopian tube is damaged or scarred, it is known as a mid-segment blockage. This is typically caused by tubal ligation or the reversal of a tubal ligation.
Distal tubal blockage: Located toward the end of the tube, a distal tubal blockage causes the fallopian tube to be partially or entirely blocked. This blockage involves the fibria (finger-like projections of the tube). A blocked distal tube frequently dilates and accumulates toxic fluid (hydrosalpinx).

CAUSES OF BLOCKED FALLOPIAN TUBES

Tubal factor infertility is often caused by a pelvic infection such as gonorrhea, chlamydia or resultant pelvic inflammatory disease. Endometriosis, which causes tissue that normally lines the uterus to grow outside of the uterus, can damage or occasionally cause a block in fallopian tubes.

Damaged fallopian tubes can also be caused by prior pelvic or abdominal surgery, including for ectopic pregnancy or a ruptured appendix. The location of these surgeries increases the risks of tubal damage.

SYMPTOMS OF TUBAL FACTOR INFERTILITY

Many women suffering from tubal factor infertility may experience no symptoms other than the inability to get pregnant. Some women may experience lower abdominal pain in addition to infertility.

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