Treatment of utero-tubal factors in female infertility

J Bonnar
Irish journal of medical science · 1979 · doi:10.1007/BF02938182 · PMID:500337
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Accurate diagnosis and surgical intervention can improve pregnancy prospects for infertility caused by exosalpinx disease or uterine malformations, but not for severe endosalpinx damage.

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This paper reviews diagnosis and treatment of utero-tubal causes of female infertility, emphasizing the fallopian tube’s physiological role in ovum pick-up and transport and noting that tubal disease causes vary by country. It describes combined hysterosalpingography and laparoscopy as enabling more accurate diagnosis, reporting that pregnancy prognosis is poor when endosalpinx is diseased with destroyed cilia and that tubal surgery offers little benefit in such cases, while problems confined to the exosalpinx (as in endometriosis) have higher success after surgery to restore normal tubal and ovarian anatomy. It also notes that reversal of sterilization can yield good pregnancy prognosis and that uterine malformations associated with recurrent abortion improve outcomes when treated appropriately. This paper discusses endometriosis in the context of exosalpinx damage affecting tubal factors and their surgical outcomes, making it directly relevant to endometriosis-related infertility.

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Summary THE incidence and aetiology of tubal disease as a cause of infertility varies from country to country. In recent years more information has become available on the physiological function of the fallopian tube and its crucial role in the ovum pick-up as well as transport. Accurate diagnosis of utero-tubal factors is now possible by the combined techniques of hysterosalpingography and laparoscopy. Where the endosalpinx is diseased or damaged and the cilia destroyed, the prognosis for pregnancy will invariably be poor and tubal surgery has little to offer. Where the problem is confined to the exosalpinx as in endometriosis, surgery to restore the normal anatomy of the tubes and ovaries has a high success rate. Reversal of sterilization is now possible and has a good prognosis for pregnancy. Uterine malformations may be the cause of recurrent abortion and treatment of these abnormalities greatly improves the prospects for successful pregnancy. Similar content being viewed by others References Asherman, J. G. 1950. Traumatic intrauterine adhesions. J. Obstet. Gynaec. Brit. Emp. 57, 892. Bellina, J. H. 1975. Lasers in Gynaecology. Obstet. Gynaec. Observer, 14 35. Gomel, V 1977. Tubal reanastomosis by microsurgery. Fertility and Sterility, 28, 59. Greenblatt, R. B., Borenstein, R., Hernandez-Ayup, S. 1974. Experiences with Danazol (an antigonadotrophin) in the treatment of infertility. Am. J. Obstet. Gynec. 118, 783. Kistner, R. W. 1959. The treatment of endometriosis by inducing pseudopregnancy with ovarian hormones. Fertility and Sterility 10, 539. Siegler, A. M. 1977. Surgical treatments for tuboperitoneal causes of infertility since 1967. Fertility and Sterility, 28, 1019. Strassman, P. 1907. Die operative vereinigung eines dobbelten uterus. Zentralbl Gynaekol. 43, 1322. Williams, E. A. 1977. Aspects of fallopian tube surgery.In Recent Advances in Obstetrics and Gynaecology. Eds. J. Stallworthy and G. Bourne. Churchill Livingstone Edinburgh, p. 219. Author information Authors and Affiliations Rights and permissions About this article Cite this article Bonnar, J. Treatment of utero-tubal factors in female infertility. IJMS 148 (Suppl 1), 58–65 (1979). https://doi.org/10.1007/BF02938182 Issue date: DOI: https://doi.org/10.1007/BF02938182

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Fallopian Tube Diseases Infertility, Female Uterus Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Infertility, Female Infertility, Female Infertility, Female Ovum Transport Pregnancy Prognosis Sterilization Reversal Sterilization, Tubal Uterus Uterus

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