What is Tubal Factor Infertility?
Damage to fallopian tubes can cause infertility and other complications
By: Laura Reuter, M.D.
Jun 06, 2018
The fallopian tubes play a vital role in reproduction. These tubes serve as the passageway for eggs to travel from the ovaries to the uterus during ovulation. If these tubes are blocked or damaged, making conception difficult or impossible, we call this “tubal factor” infertility.
How do tubes become damaged?
There are several reasons that tubes may become blocked or damaged. While you can be born with tubal abnormalities, it is most often the result of an infection, primarily sexually transmitted infections (STIs). Chlamydia, for example, can migrate from the cervix up to the fallopian tubes, potentially damaging them from the inside out.
A ruptured appendix or other abdominal infection can also cause tubal damage. When an infection has reached these reproductive organs, it is called pelvic inflammatory disease (PID).
Some women do not experience any symptoms of PID. Others experience pelvic pain, vaginal discharge or fever. If you have these symptoms, primarily pain, you should see your OBGYN.
How do I know if my tubes are damaged?
If you don’t have any noticeable symptoms of PID, you may not know if your fallopian tubes are damaged or blocked unless you have trouble getting pregnant. Some women are not even aware that they have had an STI, which has resulted in this tubal damage.
The primary way we identify tubal damage or blockages is with an x-ray exam called a hysterosalpingogram (HSG). During this test, dye is injected into the uterus and fallopian tubes and a physician, typically a gynecologist or radiologist, evaluates the movement of this dye to spot blockages and abnormalities.
Based on this test, a fertility specialist can determine the appropriate next steps.
If I have damaged tubes, what does that mean for me?
Infertility is a common result of tubal damage, but conception is not necessarily impossible. Other than infertility, the primary risk involved with tubal damage is the potential for an ectopic pregnancy.
An ectopic pregnancy is when an embryo — a joined egg and sperm — implant outside of the uterus, where a normal pregnancy occurs. This most often occurs when the embryo does not travel down the fallopian tube, instead implanting within the narrow tube. This is called a tubal pregnancy.
A tubal or other ectopic pregnancy is not sustainable. The fertilized egg cannot continue to grow within the confines of the tube, and the potential for tubal rupture can be very dangerous. If left untreated, an ectopic pregnancy can cause the tube to burst, leading to life-threatening internal bleeding.
Some women discover that they have tubal damage after having had an ectopic pregnancy. And after you have one ectopic pregnancy, you have a higher risk of future ectopic pregnancies.
Can I have a successful pregnancy with damaged tubes?
While surgery is sometimes used to correct mild tubal disease, it is typically not recommended for significantly damaged tubes due to the heightened risk of ectopic pregnancy. Tubal surgery has a very limited role and reduced chance of success with severely blocked or damaged tubes. In fact, a highly damaged tube may result in an intermal buildup of toxic fluid, which is called a hydrosalpinx. Many fertility specialists will advise surgical removal of the hydrosalpinx before proceeding with in vitro fertilization (IVF) treatment.
Because of this, IVF provides the strongest chance of a healthy pregnancy for someone with tubal damage. The process of IVF bypasses the fallopian tubes entirely to achieve a pregnancy.
During IVF, the egg and sperm are joined in a lab, and the resulting embryo or embryos are implanted directly into the uterus. We see high success rates with IVF for women with tubal factor infertility.
Whatever your specific situation, a fertility specialist can help guide you through the most appropriate options for you.
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