Causes of Poorly Functioning Fallopian Tubes
Tubal disease affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage. Treatment for tubal disease is most commonly surgery and, owing to the advances in microsurgery and lasers, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30% overall,
with certain procedures having success rates up to 65%. The main causes of tubal damage include:
(1) Infection
Caused by both bacteria and viruses and usually transmitted sexually, these infections commonly cause inflammation
resulting in scarring and damage. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at
both ends and fluid collects in the tube.
(2) Abdominal Diseases
The most common of these are appendicitis and colitis, causing inflammation of the abdominal cavity which can affect the
fallopian tubes and lead to scarring and blockage.
(3) Previous Surgeries
This is an important cause of tubal disease and damage. Pelvic or abdominal surgery can result in adhesions that alter the
tubes in such a way that eggs cannot travel through them.
(4) Ectopic Pregnancy
This is a pregnancy that occurs in the tube itself and, even if carefully and successfully overcome, may cause tubal damage
and is a potentially life-threatening condition.
(5) Congenital Defects
In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.
Endometriosis
Approximately 10% of infertile couples are affected by endometriosis. Endometriosis affects five million US women, 6-7% of all females. In fact, 30-40% of patients with endometriosis are infertile. This is two to three times the rate of infertility in the general population. For women with endometriosis, the monthly fecundity (chance of getting pregnant) diminishes by 12 to 36%. This condition is characterized by excessive growth of the lining of the uterus, called the endometrium. Growth occurs not only in the uterus but also elsewhere in the abdomen, such as in the fallopian tubes, ovaries and the pelvic peritoneum. A positive diagnosis can only be made by diagnostic laparoscopy, a test that allows the physician to view the uterus, fallopian tubes, and pelvic cavity directly. The symptoms often associated with endometriosis include heavy, painful and long menstrual periods, urinary urgency, rectal bleeding and premenstrual spotting. Sometimes, however, there are no symptoms at all, owing to the fact that there is no correlation between the extent of the disease and the severity of the symptoms. The long term cumulative pregnancy rates are normal in patients with minimal endometriosis and normal anatomy. Current studies demonstrate that pregnancy rates are not improved by treating minimal endometriosis.
Additional Factors
(1) Other variables that may cause infertility in women:
It is well-known that certain personal habits and lifestyle factors impact health; many of these same factors may limit a
couple's ability to conceive. Fortunately, however, many of these variables can be regulated to increase not only the
chances of conceiving but also one's overall health.
The ability to conceive may be affected by exposure to various toxins or chemicals in the workplace or the surrounding
environment. Substances that can cause mutations, birth defects, abortions, infertility or sterility are called reproductive
toxins. Disorders of infertility, reproduction, spontaneous abortion, and teratogenesis are among the top ten work-related
diseases and injuries in the U.S. today. Despite the fact that considerable controversy exists regarding the impacts of
toxins on fertility, four chemicals are now being regulated based on their documented infringements on conception.
Tubal disease affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage. Treatment for tubal disease is most commonly surgery and, owing to the advances in microsurgery and lasers, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30% overall,
with certain procedures having success rates up to 65%. The main causes of tubal damage include:
(1) Infection
Caused by both bacteria and viruses and usually transmitted sexually, these infections commonly cause inflammation
resulting in scarring and damage. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at
both ends and fluid collects in the tube.
(2) Abdominal Diseases
The most common of these are appendicitis and colitis, causing inflammation of the abdominal cavity which can affect the
fallopian tubes and lead to scarring and blockage.
(3) Previous Surgeries
This is an important cause of tubal disease and damage. Pelvic or abdominal surgery can result in adhesions that alter the
tubes in such a way that eggs cannot travel through them.
(4) Ectopic Pregnancy
This is a pregnancy that occurs in the tube itself and, even if carefully and successfully overcome, may cause tubal damage
and is a potentially life-threatening condition.
(5) Congenital Defects
In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.
Endometriosis
Approximately 10% of infertile couples are affected by endometriosis. Endometriosis affects five million US women, 6-7% of all females. In fact, 30-40% of patients with endometriosis are infertile. This is two to three times the rate of infertility in the general population. For women with endometriosis, the monthly fecundity (chance of getting pregnant) diminishes by 12 to 36%. This condition is characterized by excessive growth of the lining of the uterus, called the endometrium. Growth occurs not only in the uterus but also elsewhere in the abdomen, such as in the fallopian tubes, ovaries and the pelvic peritoneum. A positive diagnosis can only be made by diagnostic laparoscopy, a test that allows the physician to view the uterus, fallopian tubes, and pelvic cavity directly. The symptoms often associated with endometriosis include heavy, painful and long menstrual periods, urinary urgency, rectal bleeding and premenstrual spotting. Sometimes, however, there are no symptoms at all, owing to the fact that there is no correlation between the extent of the disease and the severity of the symptoms. The long term cumulative pregnancy rates are normal in patients with minimal endometriosis and normal anatomy. Current studies demonstrate that pregnancy rates are not improved by treating minimal endometriosis.
Additional Factors
(1) Other variables that may cause infertility in women:
- At least 10% of all cases of female infertility are caused by an abnormal uterus. Conditions such as fibroid, polyps, and adenomyosis may lead to obstruction of the uterus and Fallopian tubes.
- Congenital abnormalities, such as septate uterus, may lead to recurrent miscarriages or the inability to conceive.
- Approximately 3% of couples face infertility due to problems with the femaleís cervical mucus. The mucus needs to be of a certain consistency and available in adequate amounts for sperm to swim easily within it. The most common reason for abnormal cervical mucus is a hormone imbalance, namely too little estrogen or too much progesterone.
It is well-known that certain personal habits and lifestyle factors impact health; many of these same factors may limit a
couple's ability to conceive. Fortunately, however, many of these variables can be regulated to increase not only the
chances of conceiving but also one's overall health.
- Diet and Exercise Optimal reproductive functioning requires both proper diet and appropriate levels of exercise. Women who are significantly overweight or underweight may have difficulty becoming pregnant.
- Smoking Cigarette smoking has been shown to lower sperm counts in men and increases the risk of miscarriage, premature birth, and low-birth-weight babies for women. Smoking by either partner reduces the chance of conceiving with each cycle, either naturally or by IVF, by one-third.
- Alcohol Alcohol intake greatly increases the risk of birth defects for women and, if in high enough levels in the motherís blood, may cause Fetal Alcohol Syndrome. Alcohol also affects sperm counts in men.
- Drugs Drugs, such as marijuana and anabolic steroids, may impact sperm counts in men. Cocaine use in pregnant women may cause severe retardations and kidney problems in the baby and is perhaps the worst possible drug to abuse while pregnant. Recreational drug use should be avoided, both when trying to conceive and when pregnant.
The ability to conceive may be affected by exposure to various toxins or chemicals in the workplace or the surrounding
environment. Substances that can cause mutations, birth defects, abortions, infertility or sterility are called reproductive
toxins. Disorders of infertility, reproduction, spontaneous abortion, and teratogenesis are among the top ten work-related
diseases and injuries in the U.S. today. Despite the fact that considerable controversy exists regarding the impacts of
toxins on fertility, four chemicals are now being regulated based on their documented infringements on conception.
- Lead Exposure to lead sources has been proven to negatively impact fertility in humans. Lead can produce teratospermias (abnormal sperm) and is thought to be an abortifacient, or substance that causes artificial abortion.
- Medical Treatments and Materials Repeated exposure to radiation, ranging from simple x-rays to chemotherapy, has been shown to alter sperm production, as well as contribute to a wide array of ovarian problems.
- Ethylene Oxide A chemical used both in the sterilization of surgical instruments and in the manufacturing of certain pesticides, ethylene oxide may cause birth defects in early pregnancy and has the potential to provoke early miscarriage.
- Dibromochloropropane (DBCP) Handling the chemicals found in pesticides, such as DBCP, can cause ovarian problems, leading to a variety of health conditions, like early menopause, that may directly impact fertility.
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