Subfertility - tubal disease

Question 1

Causes

Answer 1

Infection
Endometriosis
Previous surgery/sterilisation

Question 2

Infection

Answer 2

PID, especially due to STIs
Adhesions within and around tubes
Laparoscopic adhesiolysis and salpingostomy (increased rates of ectopic pregnancy)
IVF if surgery fails

Question 3

Endometriosis

Answer 3

Role in infertility poorly understood
Laparoscopic surgery to remove endometriotic deposits improves fertility even in mild cases
Medical treatment not used as supresses ovulation
IVF if unsuccessful

Question 4

Pelvic surgery/sterilisation

Answer 4

Adhesions
Laparoscopic adhesiolysis and salpingostomy
IVF often needed

Question 5

Detection of tubal damage

Answer 5

Laparoscopy and dye test
Hysteroscopy
Hysterosalpingogram (if no risk factors for tubal disease and no signs or symtoms suggestive of endometriosis