Tubal Factor Infertility
Tubal Factor Infertility
Between 20-25 percent of all cases of infertility are tubal factor related. Tubal factor infertility includes cases of blocked fallopian tubes, partially blocked fallopian tubes, one of the two tubes blocked, tubal scarring and other types of damage to the fallopian tubes.
Often the result of endometriosis, or PCOS, tubal factor infertility, is a significant factor in problems of infertility in women. Scar tissue formed by endometrial tissue, surgery, or cysts, also creates long-term difficulties when it comes to conception. Sometimes the tubal damage is not serious. However, if after standard fertility testing is performed, there is no other obvious cause of infertility found, it is generally attributed to tubal factor infertility. Sometimes a diagnosis of unexplained infertility is given in cases where scarring is minimal.
Primary Cause Of Tubal Factor Infertility
The primary cause of tubal factor infertility is pelvic inflammatory disease which is generally caused by either gonorrhea or Chlamydia infection that has travelled from the cervix through the uterus and into the fallopian tubes. As the body releases white blood cells to combat the infection, the tubes fill with pus and the bacteria are either brought under control or they are destroyed. Sadly, the carnage that is associated with this battle is the destruction of the inner lining of the tubes, which become permanently scarred. The end of the tube or tubes may become blocked with scar tissue as can the ovaries. Damage may be minimized if the infection is caught early enough and treated aggressively with antibiotics.
Ectopic Pregnancies And PIDs
Another challenge that is associated with tubal factor infertility is ectopic pregnancy, or tubal pregnancy as it is sometimes called. In women with PID, the incidence of tubal pregnancies is 6 to 10 times higher than in women who have not had PID. A study of 745 women who had one or more episodes of PID and tried to conceive showed that 16 percent of the women were infertile from tubal blockage. Of the women who did manage to conceive, 6.4 percent of them had ectopic pregnancies.
Diagnosing The Problem
Diagnosis of tubal factor infertility is made with a hysterosalpingogram (HSG). The HSG is an x-ray examination in which a dye is injected through the cervix and into the uterine cavity. If the fallopian tubes are open, the dye easily flows through them and out into the abdominal cavity. The x-rays document the flow of dye. However, even if the tubes are open, the function of the tubes may not be normal. It is possible that the lining inside of the tube has been damaged. The dye can still flow through, but the damage remains unseen by the x-ray. Damaged tubes, even if they are open, may not be able to properly facilitate a conception or a normal pregnancy. If the damage in the tube does not allow the proper movement of the fertilized egg into the uterus, then the egg may lodge in the tube and the result is an ectopic or tubal pregnancy.
Tubal infertility is treated either with tubal surgery to repair some of the damage to the tubes, or, IVF is used as a means of conception.