Tuboperitoneal Factor.
Around 25% of female sterility cases are due to a tubal factor, meaning a disorder in the Fallopian tubes. In normal conditions, the tubes behave like a fishing rod, picking up the ovum released during ovulation, transporting spermatozoa towards the ovum and carrying the already fertilized ovum to the uterus. Damage to the tubes, whether partial because of an adherence or complete (tubal obstruction), will prevent this transfer and therefore fertilisation will not occur.
Tubal damage can occur due to infections rising from the uterine cervix or uterus towards the tubes (Pelvic Inflammatory Disease, PID), or else per continuum from the abdominal cavity, e.g. an appendicitis. The germs most frequently involved in PID are Gonorrhoea, Chlamydia and other pathogens that produce an inflammatory reaction causing an anomalous wound-healing which prevents the proper functioning of the tubes. It is estimated that, with one episode of acute pelvic disease, there will be a 30% chance of sterility. With two, there will be 50%, and with three, up to 70%.
Another type of factor causing tubal blockage is previous pelvic surgery, which may have produced adherences on the tubes or endometriosis.
Besides the impossibility of pregnancy, the tuboperitoneal factor is frequently related to ectopic pregnancy, which is when the embryo does not reach the uterine cavity due to alterations in the diameter and the inside of the tube which prevents it from being transported appropriately.
If liquid builds up in the tube (hydrosalpinx), this becomes a potential source for chronic infections. Hydrosalpinx exeresis is recommended before carrying out an IVF cycle, because the liquid can be also detrimental to embryo implantation.
The most effective reproductive treatment, more than tubal microsurgery, is complex ART techniques such as IVF/ICSI.