The mature eggs are released at the time of ovulation and must be picked up by the distal ends of the Fallopian tubes where they are fertilized by sperm. The tubes may by damaged from a previous infection, such as Chlamydia or gonorrhea or as a result of a birth defect. Scarring of the tubes may also lead to infertility by limiting the movement of the tubes. Previous pelvic surgeries and pelvic endometriosis are the most common cause of pelvic scarring.

A damaged fallopian tube or uterus can also cause infertility. These organs may be damaged from:

A previous infection, such as a sexually transmitted disease or pelvic inflammatory disease
A birth defect
Surgery to remove a tubal pregnancy
Endometriosis (tissue from the uterus growing outside the uterus)
Fibroids (a type of growth in the uterus that is usually not cancerous)
A uterus with an abnormal shape or position
Adhesions (scar tissue) inside the uterus
DES syndrome, which you may have if your mother took the medication DES to prevent a miscarriage when she was pregnant with you. In rare cases, a woman's body is allergic to sperm and destroys it. Some rare genetic problems also cause infertility. You also become less fertile as you get older, especially after age 30.

IVF is considered the first-line treatment for many women with tubal disease. Whether or not IVF is employed depends upon many factors including where the tubes were blocked, the severity of the blockage, the age of the female, and many other factors. IVF is more successful on a "per cycle basis" than tubal surgery; however, if the tubes can be repaired there is no limit to the number of times pregnancy can be attempted via intercourse.

Robert B. McWilliams, MD Reproductive Endocrinology and Gynecology

Tubal Disease and Fertility

Robert B. McWilliams, MD
Reproductive Endocrinology
and Gynecology