\u201cIt\u2019s not you, it\u2019s your tubes.\u201d<\/p>\n\n\n\n
It\u2019s a phrase no one expects to hear when trying to grow their family. Picture this: fallopian tubes are supposed to be like those fancy water slides at amusement parks\u2014smooth, open, and ready to whoosh that egg right along to its destination. But for many women, these internal pathways are more like a traffic jam during rush hour. <\/p>\n\n\n\n
Tubal factor infertility\u2014the medical term for when your fallopian tubes aren’t cooperating with your baby-making plans\u2014affects about 30% of women<\/a> dealing with fertility challenges, according to the American Society for Reproductive Medicine (ASRM).\u00a0<\/p>\n\n\n\n But what does that actually mean? What causes tubal factor infertility? Can it be fixed? And most importantly\u2014what options do you have? Whether you’re navigating this diagnosis yourself or supporting someone who is, understanding tubal factor infertility is the first step toward empowerment and informed decision making. Let’s unpack what\u2019s really going on\u2014and what comes next.<\/p>\n\n\n\n Tubal factor infertility occurs when a woman’s fallopian tubes are blocked, damaged, or otherwise not functioning properly. These small but mighty tubes play a crucial role<\/a> in conception\u2014they’re the meeting spot where sperm and egg come together, and the pathway that guides a zygote to the uterus.<\/p>\n\n\n\n When these tubes aren’t working correctly, several problems can occur:<\/p>\n\n\n\n The fallopian tubes are delicate structures, only about the width of a spaghetti noodle, with a complex internal environment. They’re not just passive tunnels between the ovaries and the uterus\u2014they contain specialized cells<\/a> that help transport both egg and sperm with gentle, wave-like movements, and they secrete substances that nourish and protect both the sperm cells and the egg.<\/p>\n\n\n\n There are several types of tubal damage that can cause tubal blockages<\/a> or impair tubal motility, both of which may cause infertility. These can occur in different parts of the fallopian tubes:<\/p>\n\n\n\n There can also be scar tissue damage around the outside<\/em> of the fallopian tubes. Finally, the tube or tubes can be filled with fluid, called hydrosalpinx<\/a>.\u00a0<\/p>\n\n\n\n What makes tubal factor infertility particularly challenging is that many women have no symptoms<\/a> until they try to conceive. Unlike other fertility issues that might cause irregular periods or pain, damaged tubes often don’t send any warning signals. For this reason, tubal blockage or damage is sometimes called a “silent” cause of infertility<\/a>\u2014you likely won\u2019t know about blockages or damage until you\u2019re trying to conceive.<\/p>\n\n\n\n Unlike other fertility issues that might cause irregular periods or pain, damaged tubes often don’t send any warning signals. <\/p><\/blockquote><\/figure>\n\n\n\n (For more about the parts of the fallopian tube and what can cause blockages, reference our fallopian tubes primer.)<\/p>\n\n\n\n Pelvic inflammatory disease (or PID) is one of the leading causes of tubal factor infertility [1]. It can occur when a sexually transmitted infection (STI) is left untreated, causing irritation or scarring to form on the fallopian tubes. This can also easily lead to damage or blockages within the tubes. Fortunately, chlamydia and gonorrhea are two STIs that can be treated with antibiotics, so it\u2019s important to get tested and treated early on if you could be infected.<\/p>\n\n\n\n Endometriosis is a disease in which tissue similar to the endometrium (lining of the uterus or womb) grows outside<\/em> the uterus in or on nearby organs, including the bowel, ovaries, or fallopian tubes [2]. Like endometrial tissue, which is shed during your period each cycle, endometriosis lesions also bleed during \u201cthat time of the month.\u201d But because it isn\u2019t <\/em>located in the uterus, endometriosis tissue is not shed, causing pain and potentially scarring and adhesions (abnormal fusion of tissues to each other or other nearby organs). <\/p>\n\n\n\n Lesions on the fallopian tubes can cause infertility in a few ways\u2014by blocking the tube and\/or scarring the tube, negatively impacting tubal motility. Endometriosis affects up to 10% of women of reproductive age and is a major cause of infertility. <\/p>\n\n\n\n Previous surgeries\u2014such as surgery to remove endometriosis lesions or uterine fibroids<\/a>\u2014could cause tubal infertility as well, due to scarring or damage to the fallopian tubes. Remember, the tubes are the thickness of a string of spaghetti. A small nick or scar could have a big impact.<\/p>\n\n\n\n An ectopic pregnancy<\/a> occurs when implantation happens outside the uterus. In the case of a tubal ectopic pregnancy (the most common type of ectopic pregnancy), the zygote never leaves the fallopian tube, and instead implants there and begins to grow. These pregnancies are non-viable, as the fallopian tubes are not designed to nourish or sustain a pregnancy. An ectopic pregnancy must therefore be removed, both because the newly conceived life cannot survive and because it could cause fallopian tube rupture, which could be life-threatening for the mother [3].\u00a0<\/p>\n\n\n\n Ectopic pregnancy can be treated several ways (which are outlined here<\/a>), including surgery. As mentioned above, any surgery on the fallopian tubes runs the risk of damage and\/or scar tissue, leading to future infertility. It\u2019s important to share your fertility goals with your physician so the utmost care can be taken to preserve your fertility if surgery is required.<\/p>\n\n\n\n The standard first-line test when a tubal blockage is suspected is a diagnostic exam called a hysterosalpingography<\/a> (HSG). This is an x-ray procedure that can view inside the fallopian tubes and uterus, and identify any blockages.\u00a0<\/p>\n\n\n\n For an HSG, your doctor will insert a cannula through your cervix and inject contrast dye to visualize how the fluid travels up from your uterus and through the fallopian tubes, which can show if and where there\u2019s a blockage. And while the procedure is typically considered diagnostic, there is a chance that it may also be therapeutic\u2013that is, the procedure itself may flush away any (minor) debris blocking the tubes<\/a>. Usually you\u2019ll be given this test if you\u2019ve been trying to conceive for 6-12 months without success.\u00a0<\/p>\n\n\n\n While HSG is the gold standard for diagnosing tubal blockages, there are cases where it\u2019s not definitive. And the exam can be somewhat painful. Another test is sonosalpingography<\/a>, a saline-infused ultrasound [4]. This involves flushing saline and air up the uterus and through the fallopian tubes while watching via ultrasound imaging. Sonosalpingography doesn\u2019t use X-rays or contrast dye, but can still be uncomfortable.<\/p>\n\n\n\n Finally, a doctor can perform a laparoscopy<\/a>, where he or she makes a small incision in your abdomen and looks inside with a special camera. This might be required to see the specific cause or type of blockage. However, this is an expensive surgery that requires anesthesia and\u00a0 post-op recovery time, while the aforementioned procedures are typically out-patient.<\/p>\n\n\n\n Some doctors may tell you that in vitro<\/em> fertilization (IVF)\u2014the joining of an egg and sperm in a petri dish and reinsertion of a zygote back into the uterus\u2014is the only way to get pregnant with tubal factor infertility. However, there are several specialized surgeries<\/a> and procedures to unblock and repair the fallopian tubes, making natural conception possible.<\/p>\n\n\n\n Fallopian tube recanalization<\/a> is a procedure that can remove debris, mucus, or fluid that\u2019s blocking the fallopian tube. This treats proximal tubal blockages\u2014those closest to the uterus. A physician inserts a catheter up the vagina, through the uterus, and into the affected tube. After removal, a doctor will check the tube with contrast dye to make sure it\u2019s clear. This is a quick procedure, not a surgery, and doesn\u2019t require any anesthesia. Amazingly, this procedure has a pregnancy success rate of up to 90%, though results vary [5]. This website<\/a> for a restorative reproductive medicine-trained OB\/GYN who specializes in tubal factor infertility surgeries reports up to 95% success rate in reopening blocked tubes and 60-75% pregnancy rates.\u00a0<\/p>\n\n\n\n A tubotubal anastomosis can restore the middle of the fallopian tube. It\u2019s commonly performed to reverse<\/em> a tubal ligation (surgical female sterilization). It also treats blockages in the mid-segment of the fallopian tubes. This is a procedure done under general anesthesia but has a fertility success rate<\/a> of about 70% [6].<\/p>\n\n\n\n Finally, a neosalpingostomy<\/a> is a surgical procedure to treat distal tube blockages\u2014those farthest from the uterus and closest to the ovaries. It can also treat scar tissue on the tubes. This surgery is done laparoscopically (via a small incision in the abdomen with special tools and a camera) and aims to create a new opening in the tube and\/or repair or reconstruction<\/a> of the fimbriae (the finger-like projections on each fallopian tube that \u201creach out\u201d to receive a newly ovulated egg from the ovary) [7]. Pregnancy rates after this procedure tend to be lower than with other surgical procedures (for other types of blockages), though some doctors trained in restorative reproductive medicine<\/a> report rates as high as 60-70% [8].<\/p>\n\n\n\n All this to say, there are <\/em>options for you if you are dealing with infertility due to tubal blockage or damage. These procedures aim to restore or maintain your natural fertility so you can conceive.<\/p>\n\n\n\n Tubal factor infertility may be a roadblock on the path to parenthood\u2014but it doesn\u2019t have to be a dead end. Understanding what\u2019s happening inside your body<\/a> through charting your cycle (be sure to learn how from a trained instructor<\/a>!) is a great first step to addressing fertility struggles. A healthcare professional<\/a> trained in restorative reproductive medicine<\/a> can use your body\u2019s health data as reflected in your charting to recommend a path forward, utilizing appropriate diagnostic tools and treatment options. With the right information and a supportive medical team, many women facing tubal infertility do go on to have successful pregnancies. You have options on this journey.<\/p>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":"\u041f\u0440\u0438\u0447\u0438\u043d\u044b \u0438 \u0432\u0430\u0440\u0438\u0430\u043d\u0442\u044b \u043b\u0435\u0447\u0435\u043d\u0438\u044f","protected":false},"author":120,"featured_media":22562,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":true,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5368,5181,5316],"tags":[4215,4072,6352],"class_list":{"0":"post-22561","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-infertility","8":"category-reproductive-and-menstrual-disorders","9":"category-trying-to-conceive","10":"tag-fallopian-tube","11":"tag-infertility","12":"tag-infertility-treatment","13":"cs-entry","14":"cs-video-wrap"},"acf":[],"yoast_head":"\nWhat is tubal factor infertility?<\/span><\/h2>\n\n\n\n
\n
Different types of tubal damage<\/span><\/h2>\n\n\n\n
\n
Causes of tubal factor infertility<\/span><\/h2>\n\n\n\n
Pelvic inflammatory disease<\/span><\/h3>\n\n\n\n
Endometriosis<\/span><\/h3>\n\n\n\n
Previous surgeries<\/span><\/h3>\n\n\n\n
Ectopic pregnancy<\/span><\/h3>\n\n\n\n
How tubal factor infertility is diagnosed<\/span><\/h2>\n\n\n\n
Hysterosalpingography (HSG)<\/span><\/h3>\n\n\n\n
Sonosalpingography<\/span><\/h3>\n\n\n\n
Laparoscopy<\/span><\/h3>\n\n\n\n
Fertility treatment options beyond in vitro <\/em>fertilization<\/span><\/h2>\n\n\n\n
Fallopian tube recanalization<\/span><\/h3>\n\n\n\n
Tubotubal anastomosis<\/span><\/h3>\n\n\n\n
Neosalpingostomy<\/span><\/h3>\n\n\n\n
The bottom line on tubal factor infertility<\/span><\/h2>\n\n\n\n
References:<\/span><\/h4>\n\n\n\n[1] Jennings LK, Krywko DM. Pelvic Inflammatory Disease. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK499959\/<\/a><\/p>\n\n\n\n[2] Jiao HN, Song W, Feng WW, Liu H. Diagnosis and treatment of tubal endometriosis in women undergoing laparoscopy: A case series from a single hospital. World J Clin Cases. 2022 Nov 26;10(33):12136-12145. doi: 10.12998\/wjcc.v10.i33.12136. PMID: 36483829; PMCID: PMC9724517.<\/p>\n\n\n\n[3] Vadakekut ES, Gnugnoli DM. Ectopic Pregnancy. [Updated 2025 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539860\/<\/a><\/p>\n\n\n\n[4] Robertshaw, I. & Martinez, A. & Batcheller, A. & DiPaola, K. & Sroga, Julie & Lindheim, Steven. (2014). Air bubble saline infused sonography (SIS) is equivalent to hysterosalpingogram (HSG) in assessment of tubal patency. Fertility and Sterility. 102. e281-e282. 10.1016\/j.fertnstert.2014.07.958. <\/p>\n\n\n\n[5] Shen H, Cai M, Chen T, et al. Factors affecting the success of fallopian tube recanalization in treatment of tubal obstructive infertility. J Int Med Res. 2020 Dec;48(12):300060520979218. doi: 10.1177\/0300060520979218. PMID: 33322979; PMCID: PMC7745608.<\/p>\n\n\n\n[6] Berger GS, Thorp JM Jr, Weaver MA. Effectiveness of bilateral tubotubal anastomosis in a large outpatient population. Hum Reprod. 2016 May;31(5):1120-5. doi: 10.1093\/humrep\/dew038. Epub 2016 Mar 14. PMID: 26980770; PMCID: PMC4840024.<\/p>\n\n\n\n[7] Kasia JM, Ngowa JD, Mimboe YS, et al. Laparoscopic Fimbrioplasty and Neosalpingostomy in Female Infertility: A Review of 402 Cases at the Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital in Yaound\u00e9-Cameroon. J Reprod Infertil. 2016 Apr-Jun;17(2):104-9. PMID: 27141465; PMCID: PMC4842231.<\/p>\n\n\n\n[8]Lee, D, Patton, P, Glob. libr. women’s med<\/em>., (ISSN: 1756-2228)<\/em> 2008; DOI 10.3843\/GLOWM.10370<\/p>\n\n\n\n