Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 6;13(13):3961.
doi: 10.3390/jcm13133961.

Incidence and Causes of Tubal Occlusion in Infertility: A Retrospective Cohort Study

Daniel Mayrhofer  1 , Iris Holzer  1 , Judith Aschauer  1 , Clara Selzer  1 , John Preston Parry  2   3 , Johannes Ott  1
Affiliations

Incidence and Causes of Tubal Occlusion in Infertility: A Retrospective Cohort Study

Daniel Mayrhofer et al. J Clin Med. .

Abstract

Background and Objectives: Fallopian tubal pathology is a primary risk factor for female infertility, with simple proximal disease and proximal disease extending more distally being more common than pure distal occlusion. Proximal tubal occlusion is often attributed to ascending events, such as pelvic inflammatory disease. Conversely, while distal occlusion can also be attributable to ascending pelvic inflammatory disease, it can also have a pelvic origin, such as through endometriosis and ruptured appendicitis. The aim of this study was to identify certain causes of infertility and their association with tubal occlusion. The focus was on the location of tubal occlusion, uni- versus bilateral occlusion, and other causes of infertility, including male factors. Methods: In a retrospective study cohort study, 373 women aged between 18 and 40 years, treated from 1 January 2017 to 31 December 2022, were included. Fallopian tube patency was tested using either hysterosalpingography, hysterosalpingo-contrast sonography, or laparoscopic chromopertubation. Results: In total, 95 of 373 women (25.5%) revealed at least one occluded tube, with unilateral occlusion being more common than bilateral occlusion (60/95, 63.2% vs. 35/95, 36.8%). The majority of tubal occlusions occurred proximally (86.2%). According to the adjusted multivariate regression models, the presence of hydrosalpinx (odds ratio, OR, 13.323, 95% confidence interval, CI: 2.679-66.253, p = 0.002), myomas (OR 2.108, 95%CI: 1.008-4.409; p = 0.048), and an abnormal sperm test result of the male partner (OR 2.105, 95%CI: 1.156-3.833; p = 0.015) were statistically significant associated factors for tubal occlusion. Conclusions: Fallopian tube patency testing is still of major relevance in fertility evaluation. The presence of uterine myomas, hydrosalpinges, and a male factor significantly increase the risk.

Keywords: fallopian tube diseases; fallopian tubes; fertility; male infertility; patency testing; uterine leiomyomas.

PubMed Disclaimer

Conflict of interest statement

Johannes Ott reports personal fees from Lenus Pharma GesmbH (Vienna, Austria) outside the submitted work. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Overview of patency findings. The number of patients with bilateral patency, unilateral occlusion, or bilateral occlusion is provided in (A). The number of patency and proximal or distal occlusion per fallopian tube is shown in (B).
Figure 2
Figure 2
Summary of key findings.
See this image and copyright information in PMC

References

    1. Vander Borght M., Wyns C. Fertility and Infertility: Definition and Epidemiology. Clin. Biochem. 2018;62:2–10. doi: 10.1016/j.clinbiochem.2018.03.012. - DOI - PubMed
    1. Penzias A., Bendikson K., Falcone T., Hansen K., Hill M., Jindal S., Mersereau J., Racowsky C., Rebar R., Steiner A.Z., et al. Evidence-Based Treatments for Couples with Unexplained Infertility: A Guideline. Fertil. Steril. 2020;113:305–322. doi: 10.1016/j.fertnstert.2019.10.014. - DOI - PubMed
    1. Carson S.A., Kallen A.N. Diagnosis and Management of Infertility: A Review. JAMA. 2021;326:65–76. doi: 10.1001/jama.2021.4788. - DOI - PMC - PubMed
    1. Infertility Workup for the Women’s Health Specialist: ACOG Committee Opinion, Number 781. Obstet. Gynecol. 2019;133:e377. doi: 10.1097/AOG.0000000000003271. - DOI - PubMed
    1. Kamphuis D., van Eekelen R., van Welie N., Dreyer K., van Rijswijk J., van Hooff M.H.A., de Bruin J.P., Verhoeve H.R., Mol F., van Baal W.M., et al. Hysterosalpingo-Foam Sonography versus Hysterosalpingography during Fertility Work-up: An Economic Evaluation alongside a Randomized Controlled Trial. Hum. Reprod. 2024;39:1222–1230. doi: 10.1093/humrep/deae071. - DOI - PMC - PubMed

LinkOut - more resources