Tubal and peritoneal factor

Tubal and peritoneal factor is the main cause of subfertility in 11-30% of subfertile couples. It may refer to tubal inflammatory damage, endometriosis and adhesions of the uterus and the pelvis in general.

Tubal pathologies include:

  • adhesions,
  • occlusion of the isthmus (cornual-isthmic tubal occlusion),
  • partial occlusion of the infundibulum (prefimbrial phimosis),
  • total occlusion of the infundibulum (hydrosalpinx).

 

It is reminded that the fallopian tube consists of four parts: the interstitial or conual portion, the isthmus, the ampulla, the infindibulum and the fimbria.

Procedures for the restoration of such damage include lysis of the adhesions, fimbrioplasty, salpingostomy and tubotubal anastomosis. Nowdays, these procedures have limited application due to high pregnancy rates after assisted reproduction which bypasses the tubal factor. These procedures in the past had a wide application and aimed in treating tubal factor subfertility.

Nowadays they are considered an alternative solution to assisted reproduction and they are performed with laser laparoscopic surgery, offering satisfactory natural conception pregnancy rates in certain cases.