By: David L. Keenan, MD, FACOG, ACRM
Approximately 25% of female infertility is due to blockage of the fallopian tubes. The fallopian tubes are very delicate structures that are responsible for picking up the egg and providing the site for fertilization and early embryo development. The tube is narrowest at the inner portion that joins the uterus and then widens in the outer portion that has finger-like projection called fimbria. The fimbria are responsible for picking up the egg. The cells lining the tube produce secretions that nourish the egg and embryo. The tubes are frequently damaged by infections (e.g., chlamydia, gonorrhea) or other pelvic conditions such as endometriosis or even severe appendicitis.
Scar tissue and blockage can occur at either the inner or outer portion or in both of those regions of the tube. If blockage occurs at only the outer portion then the secretions of the tube will be unable to drain out of the end of the tube and swelling of the tube will occur. This is known as hydrosalpinx (literally water in the tube.)
There are two different approaches to treating infertility that results from tubal damage. If there is mild damage then surgical repair can be attempted. If there is severe damage then the results of surgery are poor and IVF (in vitro fertilization) is recommended to bypass the fallopian tubes.
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