Dr. Goodman is Interviewed by Fertility Authority on the Subject of Tubal Factor Infertility

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What are some causes of tubal factor infertility?

The fallopian tubes are critical for natural conception. The fimbriated ends of the tubes act as fingers to pick up the egg from the ovaries. Cilia, tiny hairs within the tube, must function normally to transport the egg and eventually the embryo through the tube into the uterus. The sperm must be able to enter the fallopian tube to meet with the egg as fertilization of the egg by the sperm occurs within the fallopian tube. Any process that damages the structure or function of the fallopian tube can adversely affect a woman’s ability to conceive and increase her chances of having an ectopic(tubal) pregnancy. Pelvic infections such as gonorrhea or chlamydia can damage both the cilia and the fimbria affecting transport of the embryo which also can increase the chances of having an ectopic pregnancy or cause tubal occlusion/ blockage. Some women may be exposed to these or other infections without being aware until testing reveals tubal disease. Previous surgery within the pelvis can result in scar tissue(adhesion) formation that can involve the fallopian tubes affecting the ability of the tube to pick up the egg. Endometriosis, often associated with painful menstrual cycles and infertility, can also cause scar tissue that can involve the fallopian tubes. Some of these conditions can damage the tube at the fimbriated ends while others may cause blockage where the tube enters the uterus.

Who is at risk for tubal infertility?

Women who have a history of pelvic infections such as gonorrhea or chlamydia or were diagnosed with PID (pelvic inflammatory disease), a history of prior pelvic surgery, especially surgery involving the fallopian tubes, ovaries or appendix, a previous ectopic pregnancy or have endometriosis are at higher risk for tubal infertility.

What are some of the ways fertility doctors address tubal factor infertility?

Tubal factor infertility may be addressed by surgery,depending on the extent of damage to the tubes, or by In Vitro Fertilization. Significantly damaged fallopian tubes are not amenable to surgical correction and may need to be ligated or removed prior to IVF.

Can tubal factor infertility be prevented, say by management of endometriosis or early monitoring in a patient with history of ectopic?

In some cases, early treatment of an ectopic pregnancy or of a pelvic infection can decrease the extent of tubal damage.

Any other advice or information?

Preventing exposure to sexually transmitted diseases is the most important step that women can take to decrease the chances of later experiencing tubal factor infertility.

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