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Anatomy of the Fallopian Tubes and Infertility

The fallopian tubes are located on either side of the uterus. They continue outwards towards the ovaries. At the end of each fallopian tube is a fimbria, or finger-like structure that reaches out towards the ovary to catch eggs when they are released. The fimbria stimulates the ovary when it is time for ovulation. The cilia of the fimbria direct the egg down the fallopian tube towards the uterus.

This section of the fallopian tube, which contains the fimbria, is called the infundibulum. The infundibulum opens into a dilated part of the fallopian tube called the ampulla. The ampulla is where fertilization of the egg generally takes place. Once the egg is fertilized, it will travel down the isthmus, a more narrow part of the fallopian tube. Then it enters the intramural oviduct, which is basically the entrance to the uterus.

The fallopian tubes are made up of three primary layers. The first and innermost layer of the fallopian tubes is called the mucosa. This layer secretes mucus and protects the fallopian tubes. The mucosa has a distinct appearance and can help differentiate between the portions of the fallopian tubes described above. The second layer of the fallopian tubes is called the muscularis externa. This layer is basically a layer of muscle tissue capable of contracting. These contractions help move fluid and eggs through the fallopian tubes. The third layer is the serosa. This is a smooth outer lining.

Problems with the fallopian tubes can lead to infertility. Blockages, inflammation and dysfunction of the fallopian tubes are common causes of infertility. Pelvic inflammatory disease affects the uterus, fallopian tubes and/or ovaries. Inflammation inside the fallopian tube can prevent the passage of an egg and inhibit the chances of a successful pregnancy. This inflammation can eventually cause tissues to stick together and turn into a scar. Scar tissue and adhesions are common causes of blockage in the fallopian tubes. Pelvic inflammatory disease is most commonly caused by sexually transmitted diseases or bacterial infections, although other causes are also possible.

Tubal occlusion or blockage can be tested by x-ray. A dye is injected into the cervix. It travels up through the uterus and into the fallopian tubes. If the dye spills out into the abdominal cavity, then there isn’t a complete blockage in the tube. This procedure is called a hysterosalpingogram. There may be a partial blockage still present, or the tube itself may not be functional enough to transport an egg all the way to the uterus.

If there isn’t a complete blockage of the fallopian tube, then a laparoscopy can be performed to assess the tubal damage. Sometimes surgery can correct tubal damage, or in vitro fertilization may be recommended by your doctor or infertility specialist.

Dr. Eric Daiter

About the Author: Eric Daiter is the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC, a leading NEW JERSEY INFERTILITY CENTER that offers a complete range of MALE INFERTILITY AND FEMALE INFERTILITY TREATMENT. For more information on The NJ Center for Fertility and Reproductive Medicine and Dr. Eric Daiter please visit www.drericdaitermd.com.

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