Role of Fallopian Tubes in Endometriosis-Related Infertility

In: Endometriosis-related Infertility · 2024 · pp. 103–111 · doi:10.1007/978-3-031-50662-8_9 · W4392309426
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Tubal endometriosis, which can manifest in various ways and is difficult to diagnose, may cause infertility through blockage, adhesions, hydrosalpinx, or altered tubal function.

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This chapter reviews how the fallopian tubes contribute to endometriosis-related infertility, focusing on tubal endometriosis as a heterogeneous condition that can infiltrate different tubal layers and may extend into the lumen. It highlights that tubal endometriosis often lacks specific clinical symptoms and is frequently not detectable by transvaginal ultrasonography, and even laparoscopic visualization may miss microscopic disease in otherwise normal-appearing tubes. The chapter describes multiple possible pathways to tubal dysfunction in endometriosis—including blockage, adhesions, hydrosalpinx, and altered ciliary activity and peristalsis—noting that these causes can coexist, making it difficult to separate their individual contributions, and explicitly stating the diagnostic limitation. This paper is centrally about endometriosis — it specifically reviews the role of fallopian tube pathology and tubal dysfunction in endometriosis-related infertility.

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Abstract

Up to 30% of women with endometriosis exhibit some form of tubal involvement. Tubal endometriosis is a heterogeneous disease. It may infiltrate only the tubal serosa or subserosa (peritoneal endometriosis), infiltrate the myosalpinx, and grow into the tubal lumen. Tubal endometriosis lacks specific clinical symptoms, and, in most patients, transvaginal ultrasonography does not allow it to diagnose. In addition, the visualization of the fallopian tube during laparoscopy may not be enough for accurate diagnosis because microscopic tubal endometriosis may be present in macroscopically normal fallopian tubes. Causes of tubal dysfunction in endometriosis may be tubal blockage, adhesions, and hydrosalpinx. These conditions can coexist and are often interlinked; therefore, it is difficult to distinguish the exact contribution of each cause of abnormal tubal function. In addition, the fallopian tubes of women with endometriosis may have an abnormal function (such as altered ciliary activity and peristalsis). Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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