Silvia Azaña, an embryologist at inviTRA, explains in this video why female infertility due to tubal factor can occur:
Although sometimes unknown, the involvement of the fallopian tubes can be due to different causes.
One of them would be pelvic infection, the most frequent cause of tubal injury. This type of infection can originate in the reproductive system or in nearby sites such as the appendix.
Among the responsible microorganisms are chlamydia and gonorrhea, both causes of sexually transmitted infections.
If these infections are not treated properly and on time, the inflammatory process, pelvic inflammatory disease, will trigger the appearance of adhesions. These adhesions can affect tubal functionality, thus potentially causing fertility problems due to tubal factor.
Adhesions are made of scar tissue that forms between the pelvic organs and can cause them to stick together and lose their functionality.
Another cause would be endometriosis. Endometriosis is a disease in which endometrial tissue is present outside the uterine cavity. It implants in other locations, such as the fallopian tubes or the ovaries.
Therefore, endometriosis can cause tubal obstructions and also pelvic adhesions that hinder the mobility of the fallopian tubes.
Another possible cause would be hydrosalpinx.
It's an alteration of the fallopian tubes characterized by the accumulation of fluid inside them. This causes the tube to dilate and, furthermore, to become obstructed. The most common cause of hydrosalpinx is a previous pelvic infection.
Additionally, it can affect the pregnancy rate after in vitro fertilization (IVF), and the fluid that accumulates in the hydrosalpinx can reach the uterus and thus affect embryo implantation.
There would also be other aspects that can impede the functionality of the fallopian tubes and thus be a cause of tubal factor:
- Previous pelvic surgeries, as they can cause adhesions that limit the activity of the tubes.
- Ectopic pregnancy resulting in removal of the tube (salpingectomy).
- Tubal ligation
- Congenital malformations of the tubes.Any alteration in the fallopian tubes that affects their permeability and freedom of movement is a cause of tubal factor infertility.
