Tubal damage is one of the most common causes of infertility accounting for fifteen to twenty-five percent of all infertility cases. The damage to the fallopian tubes can be the result of a variety of causes. Most of the time the damage to the fallopian tubes is completely unknown to the woman as there are rarely symptoms other than infertility. Some women, however, have severe pain around the time of their period and may also have irregular or heavy periods. However, this is often attributed by the women to her period as it is what she considers normal.

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Tubal Damage

The term tubal damage is used to describe a number of problems found within the fallopian tubes. Adhesions along the tube can make it more difficult for the tube to pick up an egg. Damage to the lining of the tube can keep the sperm from reaching an egg. A blockage in the tube can prevent a fertilized egg from reaching the uterus and increase the chances of an ectopic pregnancy. There are several causes of tubal damage. Some of the most common are infections like gonorrhea, chlamydia, pelvic infection, infection in other areas of the body that spread to the fallopian tubes, congenital abnormalities, and prior surgery involving the fallopian tubes. There are several tests that can be utilized to diagnose tubal problems. An ultrasound is often the starting point for these tests. A health fallopian tube is usually invisible to this test, if it shows up in an ultrasound it is a good indication that there has been some damage. 

Endometriosis

Another cause of tubal damage is endometriosis. Endometriosis is a common disease in which the cells that are typically found inside the womb begin to grow outside of the womb. While these cells can grow in the ovaries, bowels, bladder, they create tubal damage when they grow inside the fallopian tubes. Every month when the woman menstruates these cells, regardless of where they are in the body, act as though they were inside the womb. They attempt to shed and leave the body. When they cannot vacate the body they form cysts and can cause chronic inflammation and adhesions which damage the tubes. While endometriosis can occur in women under thirty it usually affects women in their thirties and forties. Most women with endometriosis are fertile, however, they have trouble conceiving because of the damage to their fallopian tubes. 

A pelvic exam can indicate endometriosis if the doctor observes tenderness and is able to feel ovarian cysts. Additional tests such as ultrasounds, MRI, and CAT scans can also be useful in locating and identifying cysts on the ovaries. However, neither these tests nor a physical exam is enough to diagnose endometriosis. The only way to make a diagnosis is by laparoscopy. With the use of laparoscopy a doctor can determine if the patient has endometriosis the extent of damage caused by it. There are four stages of endometriosis that are widely recognized in the medical field. The stages are minimal, mild, moderate, and severe.