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Tubal dysfunction: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Tubal dysfunction is obstruction of the fallopian tubes or epithelial dysfunction that impairs zygote motility; pelvic lesions are structural abnormalities that may interfere with fertilization or implantation.
Tubal dysfunction is a result of pelvic inflammatory disease, IUD use, ruptured appendix, adhesions after abdominal surgery, inflammatory disorders (such as tuberculosis), or ectopic pregnancy. Lesions of the pelvic organs, such as intrauterine adhesions (Asherman's syndrome), fibrous tumors that compress the fallopian tubes or distort the uterine cavity, and the presence of malformations, can impair fertility and lead to the formation of adhesions in the pelvis. Endometriosis can be the cause of tubal, uterine, or other lesions that lead to infertility.
To diagnose infertility, the fallopian tubes are examined. Most often, hysterosalpingography is performed (an X-ray examination of the uterus and fallopian tubes after the introduction of a radiopaque substance into the uterus on the 2nd to 5th day after the cessation of menstruation). Hysterosalpingography often results in functional stenosis of the fallopian tubes. This test can also detect some pelvic and intrauterine lesions. For unexplained reasons, pregnancy sometimes becomes possible after hysterosalpingography. Therefore, in these cases, additional diagnostic tests for tubal dysfunction can be delayed. Tubal lesions can be further evaluated by laparoscopy. Intrauterine and tubal lesions can be detected and further evaluated by sonohysterography (injection of isotonic saline into the uterus during ultrasonography) or hysteroscopy.
Diagnosis and treatment of tubal dysfunction are most often performed simultaneously during laparoscopy or hysteroscopy. During laparoscopy, pelvic adhesions can be separated or pelvic endometriosis lesions can be coagulated with laser or current. Similarly, during hysteroscopy, adhesions can be separated and submucous myomatous nodes and intrauterine polyps can be removed.
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