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Tubal Factor Infertility

In natural unassisted conception, the fallopian tubes play an integral part in establishing pregnancy.  First, an egg which is ovulated from the adjacent ovary must be picked up by the finger-like projections at the end of the tube.  The ovulated egg is safe-guarded in the ampullary segment of the tube until it is fertilized by sperm.  The tube nurtures the resulting embryo for the next five days as it traverses the length of the tube before entering the uterus.  Tubal factor infertility pertains to tubal damage which precludes interaction between egg and sperm and/or prevents the proper movement of embryos along the tube for uterine implantation.

A variety of disease entities may lead to tubal factor infertility.  Proximal tubal disease (damage/occlusion of the fallopian tube in the region where the tube enters the uterus) may occur secondary to menstrual debris, endometriosis, or certain infectious etiologies.  Distal tubal disease (damage/occlusion of the distal part of the tube responsible for egg pick-up) may occur following pelvic infection, surgery, or endometriosis.

The diagnosis of tubal damage is established with a pelvic x-ray called a hysterosalpingogram (HSG).  The test involves the injection of dye into the uterine cavity and a simultaneous x-ray of the uterus and tubes, which illustrates the dispersion of dye through the pelvic organs.

The California Center for Reproductive Health offers both advanced microsurgical treatments as well as in vitro fertilization as therapy for tubal factor infertility.