Tubal damage is a common cause of infertility in women.

Tubal problem may arise due to:

1. Infection -This is the commonest cause of tubal damage.

• Sexually transmitted diseases
• Tuberculosis
• After an abortion, miscarriage or delivery
• From wearing an IUCD
• Spread of infection from internal organs such as appendicitis or bowel infection

Many pelvic infections have no symptoms at all, but can cause damage, sometimes irreversibly, to the tubes.

2. Previous Surgery

Any surgery that involves the Fallopian tubes, ovaries and uterus can cause adhesions. Sometimes abdominal surgery can also result in adhesions that may affect the tube eg appendicitis.Tubal ligation is a common procedure which may be regretted.

3. Previous Ectopic Pregnancy

4. Congenital abnormality

5. Endometriosis

Tubal blockage can be (either – delete) proximal, mid-tubal or distal. Proximal is when the tubal blockage is located close to the uterus (cornual), while distal is when the tubal blockage lies near the ovary (fimbrial).

Blockage of the tubes can prevent the sperm from reaching the egg, or the fertilized egg from moving into the uterus.

Damage to the fimbriae may reduce or stop their ability to pick up the egg and direct it into the Fallopian tube.

Adhesions around the tube may distort the tube or reduce their mobility, thus affecting their ability to pick up the egg.

Damage to the cells lining the tube may prevent sperm from reaching the egg or greatly reduce the chance of fertilization.