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The fallopian tubes are not mere passages for the egg to travel from the ovaries to the uterus. It is here that conception occurs and hence healthy fallopian tubes are essential for the fertilization of an egg.
Damaged fallopian tubes are the most common cause of infertility. This damage can fall under three categories.
- Blocked fallopian tubes
- One blocked and one open fallopian tube
- Tubal scarring
The third is usually an effect of pelvic infections or natural healing after a pelvic surgery. Sadly, in most cases, this condition is discovered only after infertility has been diagnosed. Other causes of fallopian tubal scarring include:
- STDs such as chlamydia trachomatis and neisseria gonorrhea
- Adhesions caused by ruptured ovarian cysts
- A history of ectopic pregnancies
Fallopian tubal scarring has no recognizable symptoms. Chronic pelvic pain is the only known symptom of this damage and that too can be seen only in severe cases of tubal scarring. On diagnosing infertility, your doctor will perform one of these tests to determine the condition of your fallopian tubes.
- Hysterosalpingogram: This is a type of X-ray. Your doctor will open the vagina with a speculum and inject a liquid into the uterus with the help of a catheter. If the liquid does not pass through the fallopian tubes, it is said to be blocked. This however, does not say much about tubal scarring.
- Laparoscopy: A small incision is made below the belly button and a slim, flexible tube with a camera is passed through the incision. This gives your doctor a clear view of the condition of your fallopian tubes. A laparoscopy can also be used to rule out other causes of infertility such as endometriosis or blocked fallopian tubes.
Treatment for infertility caused by tubal scarring is of two types:
- Surgery: This is suggested in cases where tubal scarring is minimal. Depending on the intensity and placement of scar tissue, your doctor may decide to perform one of many types of surgeries. He may choose to remove the scarred section of the fallopian tube, create a new opening (in case of blockages) or rebuild the damaged edges of the fallopian tubes.
- In Vitro Fertilization(IVF): Women with badly scarred fallopian tubes usually have poor chances of conceiving naturally. Hence, IVF is the preferred treatment route. However, your doctor may still advise you to undergo surgery and remove the damaged tubes prior to IVF to prevent the tubes from filling with fluid.
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Common Cause of Infertility in Females
Damage to fallopian tubes (tubal infertility)
When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:
Pelvic tuberculosis, a major cause of tubal infertility worldwide, although uncommon in the United States
Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may obstruct the tube and keep the egg and sperm from uniting. It can also affect the lining of the uterus, disrupting implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.
Uterine or cervical causes
Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage.
Benign polyps or tumors (fibroids or myomas) are common in the uterus, and some types can impair fertility by blocking the fallopian tubes or by disrupting implantation. However, many women who have fibroids or polyps can become pregnant.
Endometriosis scarring or inflammation within the uterus can disrupt implantation.
Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant.
Cervical stenosis, a cervical narrowing, can be caused by an inherited malformation or damage to the cervix.
Sometimes the cervix can’t produce the best type of mucus to allow the sperm to travel through the cervix into the uterus.
In some instances, a cause for infertility is never found. It’s possible that a combination of several minor factors in both partners underlie these unexplained fertility problems. Although it’s frustrating to not get a specific answer, this problem may correct itself with time.