Tubal factor infertility accounts for about 20-25% of all cases of infertility
It includes cases of completely blocked fallopian tubes and also cases with either 1 blocked tube or no blockage but tubal scarring or other damage
Tubal factor infertility is often caused by pelvic infection, such as pelvic inflammatory disease (PID), or endometriosis, or scar tissue that forms after pelvic surgery.
Laparoscopy picture of a hydrosalpinx – a fallopian tube that is blocked and dilated with fluid
This is often caused by previous pelvic inflammatory disease – PID
Testing for tubal infertility
The diagnosis of tubal factor infertility is investigated in most cases with diagnostic hystero-laparoscopy. material (dye) is injected through the cervix to the uterine cavity. If the fallopian tubes are open the dye flows into the tubes and then spills out to the abdominal cavity.
However, just because the fallopian tubes are found to be open by this “plumbing” test this does not mean that tubal function is normal. The inside lining of the fallopian tube can be severely damaged even though the tube is open and dye spills into the abdominal cavity.
Open but scarred tubes may not be able to perform the necessary functions to result in establishment of a normal pregnancy. Proper tubal function allows egg pickup and transport, fertilization, and embryo transport from the fallopian tube down into the uterus where the embryo implants.
If egg pickup, transport, and fertilization occur properly, but the tubal damage does not allow proper transport of the embryo to the uterus, implantation may occur in the tube resulting in a tubal pregnancy.
Laparoscopy can be performed to diagnose tubal damage other than complete tubal blockage.
Tubal catheterization utilizing a special scope can be done to assess the status of the mucosal lining of the inside of the tubes. This is very rarely done.
Treatment of tubal factor infertility
The treatment for tubal factor infertility is usually either IVF or ICSI.