Tubal disease refers to fallopian tubes that have been damaged. Approximately 25% of infertility in women is caused by damaged tubes.

The fallopian tubes are two hollow tubes, each about 5 inches long, that connect to each side of the uterus and reach over the surface of each ovary. The end of each fallopian tube that is next to the ovary is flared open and has many fine, delicate fingers of tissue known as fimbriae. At the time of ovulation, when the ovary releases an egg, the fimbriae pick up the egg and guide the egg into the tube. The sperm and egg meet at the end (the distal portion) of the tube. The fallopian tube lining provides the fertilized egg with nutrition and also helps the sperm as it travels to fertilize the egg. The outside and inside of this end of the tube is most important because it has to pick up the egg, hold both the sperm and egg during fertilization and start the fertilized egg (embryo) on its trip into the uterus. The embryo may stay in the fallopian tube for up to five days before it passes into the uterus and implants in the wall of the uterine cavity.

Tubal damage occurs mainly from:

• Sexually transmitted diseases (such as chlamydia or gonorrhea)
• PID (pelvic inflammatory disease)
• Previous ectopic pregnancy
• Endometriosis
• Adhesions (scar tissue in the pelvis)

Tubal disease may be suspected when a woman has a history of any of the conditions listed above. A hysterosalpingogram (HSG) or laparoscopy (surgery through the "belly button") are the procedures used to diagnose tubal disease.

If there is only a small amount of damage and the woman is young (less than 36 years old), surgery can sometimes help.

The best way to get pregnant if you have tubal damage is in vitro fertilization (IVF) which is a treatment that bypasses the tubes altogether.

Infertility due to damaged fallopian tubes is common. Fortunately, when patients are young and the tubal damage is mild, surgical techniques can help achieve pregnancy. For older women or women with severe tubal disease, in vitro fertilization offers the best chance to become pregnant.