Tubal Factor


The fallopian tubes are the transit pathway for the sperm, the egg, and the embryo. The wide portion of the tube known as Ampulla opens out on the surface of the ovary to trap the egg on its release. The delicate finger-like processes called the Fimbriae to enable this function. The Ampulla is the site of fertilization and is practically the lab of fertilization in vivo. It secretes nutrients for the early embryo and gently wafts it to the womb in the immediate post fertilization period.The tubes, therefore, have to be patent, have the adequate lining and should move the embryo. Failure to do so may result in infertility or ectopic pregnancy.The tubes are damaged by several kinds of infection s or surgery which alters the architecture of the lining and disrupt motility. The tubal patency can be checked by several tests and Bilateral damage to the tubes necessitates the use of assisted reproduction.The tubal disease often requires assisted reproduction except in proximal tubal blocks(removal either by fluoroscopy or hysteroscopy).Recanalisation is successful only if the ampulla and fimbriae are intact along with an adequate length of the tube. Removal of hydrosalpinx improves ART results as per new evidence. Thus surgery for diseased tubes has no place in the era of assisted reproduction.

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