The fallopian tubes connect the ovaries to the uterus and is the site where fertilization, the union of sperm and egg takes place. The fertilized egg then travels through the fallopian tube and implants itself in the wall of the uterus. A blockage in the fallopian tube can prevent the meeting of the egg and sperm or prevent a fertilized egg from reaching the uterus. Abnormalities of the fallopian tubes that affect fertility are referred to as tubal factors. These conditions include blocked or damaged fallopian tubes or narrowing of the tubes due to scarring. About 25-30% of all cases of infertility occur due to tubal factors.
Infection is a common cause of tubal factor infertility. Other causes include endometriosis, sexually transmitted disease (STD), ectopic (tubal) pregnancy and previous surgeries.
Tubal factor infertility is usually asymptomatic; you may not know about it unless you consult a doctor for infertility. In case of extensive tubal damage or with certain infections, you may experience chronic pelvic pain.
Your doctor diagnosises tubal factor infertility by reviewing your medical history and performing a thorough pelvic examination. Other tests such as hysterosalpingogram and laparoscopy may be ordered to confirm the diagnosis. Hysterosalpingogram or HSG is an x-ray test to view the inside of the uterus (uterine cavity) and to check whether the fallopian tubes are open or not. Laparoscopy is a minimally invasive procedure performed through a tube inserted through a small incision below your navel. It enables your surgeon to look inside the fallopian tubes to identify any blockages or narrowing due to problems such as scar tissue adhesions.
Treatment involves the following:
- Tubal cannulation: It is an outpatient procedure which involves insertion of a catheter with a wire and balloon into the fallopian tube to unblock it.
- Fimbrioplasty: The procedure involves rebuilding the fimbriae (finger-like projections of the fallopian tube) that draw the egg from the ovary into the fallopian tube.
- Salpingectomy: The surgical removal of the diseased or damaged tube.