Tubal Factor Infertility

Fallopian Tubes and Your Fertility

When it comes to fertility, it’s all about getting an egg and sperm to meet.  Tubal factor infertility is a common condition in women where the fallopian tubes are fully or partially blocked.  Here’s what you need to know.

Tubal Factor Infertility

Blockages of the fallopian tubes, known as hydrosalpinx,  affect as many as one in four couples in the U.S.   In tubal factor infertility, eggs are unable to get through the fallopian tubes to the uterus, and sperm can’t get through the obstruction to reach an egg and fertilize it.  There are several causes of tubal blockages:

  • Sexually transmitted infections (STIs) like chlamydia and gonorrhea can cause swelling or make scar tissue form, partially or totally blocking the fallopian tubes.
  • Pelvic inflammatory disease, a complication of untreated STIs, may also cause scarring.
  • Other types of infections such as peritonitis, appendicitis and diverticulitis can spread to the pelvis and infect the fallopian tubes, causing scar tissue to form.
  • Pelvic surgery may cause scarring.
  • Endometriosis can block the tubes with tissue growing where it should not.

Myths about Tubal Factor Infertility

An infertility myth many women believe is, “If my periods are regular, then I’m fertile.”  This myth ignores the essential role of the fallopian tubes in natural pregnancy.  You may be ovulating regularly, but if the egg and sperm can’t meet in the fallopian tubes, you are infertile.  Other myths about endometriosis spring from the severity of the pain and heavy periods it can cause.  Many people think that more severe symptoms mean the condition is worse.  But it’s completely possible to have endometriosis so extensive that the fallopian tubes are blocked, and not have any symptoms.

Conquering Tubal Factor Infertility

One of the first steps your reproductive endocrinologist will take in evaluating your fertility problems is to see if your fallopian tubes are open.  A hysterosalpingogram (HSG) is an X-ray of the uterus and fallopian tubes using liquid dye to see if the tubes are open.  Sometimes the procedure is done with saline and air and an ultrasound instead of X-rays.

If the tubes are blocked, the fertility specialist may recommend removing the blockage,  a procedure known as salpingostomy.  In other cases they may advise going to IVF treatment without removing the blockage.  IVF makes it possible to unite the egg and sperm in the lab, grow embryos, and transfer one or two to the uterus to implant and grow.  The patient’s age, where the blockage is, and other fertility issues will affect the treatment plan.