Infertility

Infertility is the inability to become pregnant. Women who are unable to carry a pregnancy to viability or keep having stillbirths are also considered infertile. About 15 percent of couples deal with infertility, and the cause can be traced to the woman in approximately one third of the cases. In another third, the cause is traced to the man, and the remaining cases either have unknown causes or can be traced to both the woman and the man.

A number of different conditions can cause female infertility, and many of these issues relate to the fallopian tubes. Some conditions cause a blockage of the fallopian tube, making it impossible for the egg to move from the ovary to the uterus or for the sperm to reach the egg. Conditions that are associated with this kind of structural problem of the fallopian tube include:

Endometriosis
Endometriosis is a condition in which the endometrium, or the cells that normally line the uterus, grow outside the uterus instead. It’s estimated that between 30 and 40 percent of women with endometriosis are infertile. While the exact link between infertility and endometriosis is still being researched, one theory is that endometriosis causes structural changes to the fallopian tube, which interrupts the egg’s movement to the uterus.

Another theory about the effect of endometriosis on fertility involves the peritoneum, which is the lining of the abdomen. The amount of fluid inside the peritoneum often increases in women with endometriosis, and that fluid contains substances that can negatively affect the function of the fallopian tubes.

Uterine Fibroids
Uterine fibroids are noncancerous tumors that form inside the uterus. The effect of uterine fibroids on fertility depends on their location and size. Fibroids that block the fallopian tube can prevent a fertilized egg from reaching the uterus, or they can keep sperm from reaching the egg.

Uterine fibroids can also interfere with the position of the cervix, the shape of the uterus, and the blood flow to the uterus. All these changes can have a negative effect on fertility.

Pelvic Inflammatory Disease (PID)
Sexually transmitted diseases, such as gonorrhea and chlamydia, can cause an infection in the fallopian tubes. If PID goes undiagnosed or untreated, it can cause permanent scarring of the fallopian tubes, which can block the fallopian tubes or damage the ability of the fallopian tubes to move the egg successfully from the ovary to the uterus.

Tubal Ligation
Tubal ligation is a surgical procedure that closes a woman’s fallopian tubes. It’s often referred to as having your “tubes tied.” It is possible to reverse a tubal ligation, but any surgical procedure can cause scarring of the fallopian tubes that makes it difficult for the fallopian tubes to move eggs from the ovaries to the uterus.

Birth Defects
Some women are simply born with blockages in their fallopian tubes. Surgery to remove the blockage is possible, but it many cases, it does not increase a woman’s ability to become pregnant. Surgical procedures can cause permanent scarring of the fallopian tube, which increases the risk for ectopic pregnancy.

There are many other causes of infertility not related to the fallopian tubes. Ask your provider for other causes if you believe this applies to you.