Tubal Factor

Tubal factor infertility includes problems with the fallopian tubes, including blockages of the tubes, missing or malformed tubes, or any type of problem involving the fallopian tubes.

Causes

The most common cause of tubal infertility, which is said to represent about 25 percent of the cases of female factor infertility, is from infections. Any type of infection can leave scarring in the fallopian tube. Sexually transmitted infections like gonorrhea and chlamydia are usually the most common culprits. Scarring prevents the sperm from reaching the egg or prevents the egg from entering the tube. It can also lead to an increase in ectopic pregnancies (pregnancies inside the fallopian tube). You are more likely to have an ectopic pregnancy if scarring is present because it can lead to tubal blockages.

You may also experience tubal factor infertility if you suffer from endometriosis. This can be caused by the blockages mentioned earlier. You may also experience fallopian tube problems from endometriosis if the fallopian tubes are not as open as they should be due to pelvic adhesions.

Things such as a ruptured appendix, bowel obstruction, or other type of pelvic surgery can also lead to blockages in the tubes or inflammation that creates a thickened lining. Remember, any thickening of the lining of the tubes can create a potential problem for the egg or sperm.

Determining if you have tubal factor infertility may be more difficult than once believed. If you can find no other cause for your inability to get pregnant, some practitioners may choose to call it tubal factor if some scarring is found, even if it's relatively minor scaring. However, a diagnosis of unexplained infertility may be more appropriate.

If you have been diagnosed with tubal factor infertility, it is very important that you report immediately to your practitioner if you believe you are pregnant. Your doctor will monitor you closely to make sure you do not suffer a tubal (or ectopic) pregnancy. Tubal pregnancy is the leading cause of maternal death in the first trimester.

It is also possible to be born with congenital problems of the fallopian tube. This can mean that your tubes are blocked, incomplete, or missing due to some genetic fluke prior to your birth. Treatment options for all tubal factor infertility may include surgery and in vitro fertilization.

Tubal Ligation Reversal

If you have had a tubal ligation, also known as having your tubes “tied,” then you chose a method of birth control that is considered permanent. This method of birth control is more than 99 percent effective at preventing pregnant. It's easy to see why it would create a problem if you later changed your mind and wanted to become pregnant.

There are ways to reverse a tubal ligation, however. The success of some treatments will depend on how long ago you had the surgery and what type of surgery you had done, as there are many different ways to “tie” the tubes. The good news about tubal ligation is that it merely blocks the tubes — it does not affect your cycles nor does it affect your ability to produce eggs or the quality of those eggs. Typical treatments might include surgery to reverse the tubal ligation by unblocking the tubes or the use of in vitro procedures to bypass the tubes.

Detecting Tubal Factor Issues

You may not realize that you are having tubal factor issues until you are diagnosed with infertility issues or with a tubal problem, like an ectopic pregnancy or pelvic inflammatory disease (PID). The most common way for a physician to check to see if your tubes are normal and open is called a hysterosalpingogram (HSG). This test involves X-rays of your pelvis taken while a dye is injected through your uterus. The films will show where the dye comes out and will allow your physician to see if there are any blockages along the way.

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