Problems in the Fallopian Tubes: Tubal Factor Infertility

Problems in the Fallopian Tubes Tubal Factor Infertility

The fertility problem is becoming more widespread today, not just in western nations but also in other nations. Couples in developing nations even postpone having children after the age of 30 to concentrate on their professions and financial security. 

IVF techniques are the gold standard of care when it comes to infertility, as is evident from many guidelines. However, these procedures are still expensive and have limited accessibility in many nations, not to mention that in some cases there may be a cultural or religious barrier that needs to be overcome.

What does the fallopian tube do?

The fallopian tube serves as the egg’s passageway into the uterus. The egg is released from the ovary during ovulation and taken up by finger-like fimbriae at the fallopian tube’s end. After that, the egg starts its three-day journey to the uterus. 

On the first day, it remains at the end of the tube and stays where it can be fertilized if it meets the sperm that goes up the cervix, through the uterus, and into the fallopian tube. As soon as it is fertilized, the embryo starts to divide and moves down the fallopian tube to the uterus, where it stays for another three days before being implanted. (1)

What are the main causes of problems in the fallopian tubes?

Although there are many different causes of tubal factor infertility, the main causes are:

  • tubal obstruction or occlusion (proximal, distal, unilateral, or bilateral)
  • endosalpingeal destruction
  • periadnexal adhesions
  • pelvic inflammatory disease
  • endometriosis
  • induced surgical abortion
  • ectopic pregnancy
  • abdominopelvic surgery
  • use of intrauterine devices (2)

Fallopian tubes can be damaged in many various ways. An ovulated egg cannot be picked up by the tube if the farthest end is obstructed. This may also result in the tube filling up with fluid and expanding, a condition known as a hydrosalpinx. Knowing if your obstructed tubes are causing a hydrosalpinx is crucial since the fluid that accumulates inside can cut your chances of becoming pregnant through IVF by roughly 50%. (3)

Why is the HSG test used for fallopian tubes?

The hysterosalpingogram, or HSG, is the test used to find out if your fallopian tubes are open. The dye is sent from the cervix to the uterus and out of the tubes during this test, which is often performed by a radiologist or gynecologist. The tubes are opened if the dye has leaked out, which can be seen on an X-ray. A damaged or clogged fallopian tube prevents the egg and sperm from locating one another. This mechanical impediment to fertilization is known as tubal factor infertility. 

Natural conception is prevented by blocked fallopian tubes, however, IVF can overcome this. The ovaries are stimulated to create a number of eggs during IVF, which is followed by their removal during a brief anesthetic operation. (4)

What should I do if I have a problem with my fallopian tubes?

Infertility caused by the intentional tubal factor affects patients who have already undergone tubal ligation (“tubes tied”). IVF or reattachment surgery are alternatives if you’ve had a tubal ligation and wish to become pregnant once more. 

Tubal reanastomosis is the name of the procedure, which is exclusively carried out in certain clinics. If you’ve had a tubal ligation and want to get pregnant, it’s a good idea to have a consultation with your doctor to discuss your options. IVF is typically the suggested procedure, although your age and ovarian reserve may ultimately determine the right treatment for you. (5)

Can I get pregnant without fallopian tubes?

Natural conception without fallopian tubes is not possible because the fallopian tubes are essential for transporting the egg from the ovary to the uterus. Without the fallopian tubes, there is no way for the egg to reach the uterus, where it can implant and develop into a pregnancy.

However, women who have had their fallopian tubes removed, or who are born without fallopian tubes, may still be able to conceive with the help of assisted reproductive technologies (ART) such as in vitro fertilization (IVF). 

In a salpingectomy, one or both of your fallopian tubes are surgically removed. As conception occurs, the egg travels through the fallopian tubes to the uterus. If one of your fallopian tubes is removed, you can still conceive naturally if the other fallopian tube is healthy and functional. However, if both fallopian tubes are removed, it is impossible to get pregnant naturally.

In case you have undergone a salpingectomy procedure, there is still hope for pregnancy through IVF. IVF involves the fertilization of your eggs in an IVF laboratory, followed by the transfer of the embryos into your uterus. In short, women without fallopian tubes can still conceive with the help of assisted reproductive technologies such as IVF.

Treatment Options for Fallopian Tube Blockages

For individuals grappling with tubal factor infertility, several therapeutic avenues are available, each tailored to the blockage’s severity and personal reproductive aspirations. Initially, healthcare professionals might prescribe medications. These drugs aim to alleviate inflammation or clear slight obstructions in the fallopian tubes, offering a less invasive approach.

Moreover, surgical intervention becomes a consideration when medications prove insufficient. Through laparoscopic surgery, a technique characterized by its minimally invasive nature, surgeons meticulously remove scar tissue or adhesions that cause the blockage. This procedure typically allows patients to return home the same day, minimizing hospital stay durations.

Furthermore, in situations where blockages are extensive or surgery is deemed unsuitable, In Vitro Fertilization (IVF) emerges as a beacon of hope. The process involves:

  • Extracting eggs from the ovaries.
  • Fertilizing these eggs with sperm in a controlled laboratory environment.
  • Transferring the resulting healthy embryos directly into the uterus.

This method circumvents the fallopian tubes entirely, thereby addressing severe tubal obstructions. Each treatment path is chosen after careful consideration of the individual’s condition and fertility goals, ensuring a personalized approach to overcoming tubal factor infertility.


Confino, E., & Radwanska, E. (1992). Tubal factors in infertility. Current Opinion in Obstetrics and Gynecology4(2), 197-202.

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