Fallopian tube is a winding lumen. According to clinical cases, 30% primary infertility and 80% secondary infertility are caused by tubal factors. Tubal obstruction can affect sperm and egg combine because of tubal adhesion, hydrosalpinx, tubal obstruction, fallopian tube elevation and fallopian tube bend. These symptoms are usually caused by artificial abortion, natural abortion, medical abortion, induced abortion, Caesarean birth, postnatal infection, appendicitis, intrauterine device (IUD) fitting and extraction, tuberculosis, chronic colporrhagia, unclean sexual intercourse, pelvic infection, endometriosis, etc.

1. Tubal Adhesion

Inflammation and endometriosis are the common causes of tubal adhesion. Tuberculosis infection and annex abscess are the most serious infection conditions, which usually result in adhesion between lower edge of great omentum, intestinal canal, rectum, bladder, uterine adnexa and peritoneum, posterior lobe of broad ligament, posterior peritoneum of pelvic floor, macrovascular, etc. The manifestations are tubal and ovary adhesion, fallopian tube elevation and bend.

2. Hydrosalpinx

Hydrosalpinx is a common kind of salpingitis. When salpingitis causes tubal adhesion and atresia, secretion of mucosal cells accumulates in lumen. Or, salpingitis creates isthmus and fimbrial end adhesion, the obstruction leads to fallopian tube empyema. When the pus cells in lumen are absorbed and watery liquid produced, we call it hydrosalpinx.

3. Tubal Obstruction

Tubal obstruction is caused by functional contraction of shedding embolus and organs, such as the endometrium fragments and blood clots during menstrual period. Another example is when medical and artificial abortion conducted, uterine contraction and sudden relive of vacuum suction make embryonal tissues and the annex enter fallopian tube, causes tubal obstruction, hydrosalpinx and adhesion, and finally leads to infertility.

4. Fallopian Tube-Pelvic Sidewall Adhesion Caused by Pelvic Inflammation is the Reason for Fallopian Tube Bend

The fallopian tube locates in pelvic cavity, extends outward through uterine angulus lateralis, firstly reaches uterine extremity of ovary, and then goes upwards along mesovarial margin of ovary and reaches extremitas tubalis. The interstitial portion and isthmus of fallopian tube are respectively firm while the ampulla and fimbriae are floating. Because fallopian tube and ovary are connected by ovarian proper ligament, salpingitis may lead to oophoritis that is called salpingo oophritis or annexitis.

If position changes, fallopian tube bend may happen and is normal for its movement and floating status. However, if the patient also has symptom of infertility, it could identify as steady state of fallopian tube bend, and needs immediate treatment.

Inflammation caused fallopian tube bend means fallopian tube is adhered onto the pelvic sidewall because of the pelvic inflammation. Ampulla and fimbriae should be floating, but the fimbriae cannot move when adhering with pelvic sidewall, which makes fallopian tube fail to catch eggs. Thus, eggs cannot enter the tube to meet sperm for fertilization, infertility happens. Besides, inflammation affects ovary’s ovulation and fallopian tube's movements, which also lead to infertility; or, fertilized egg cannot enter uterine cavity and stays in fallopian tube, leads to extrauterine pregnancy.

5. Fallopian Tube-Pelvic Sidewall Adhesion Caused by Pelvic Inflammation is the Reason for Fallopian Tube Elevation

The fallopian tube locates in pelvic cavity, extends outward through uterine angulus lateralis, firstly reaches uterine extremity of ovary, and then goes upwards along mesovarial margin of ovary and reaches extremitas tubalis. The interstitial portion and isthmus of fallopian tube are respectively firm while the ampulla and fimbriae are floating. Because fallopian tube and ovary are connected by ovarian proper ligament, salpingitis may lead to oophoritis that is called salpingo oophoritis or annexitis. Inflammation produces stimulation towards fallopian tube, ovary and pelvic cavity, causes adhesion, and leads to fallopian tube elevation and bend.
The fimbriae cannot move when adhering with pelvic sidewall that makes fallopian tube fail to catch eggs. Thus, eggs cannot enter the tube to meet sperm for fertilization, infertility happens. Besides, inflammation affects ovary’s ovulation and fallopian tube's movements, which also lead to infertility; or, fertilized egg cannot enter uterine cavity and stays in fallopian tube, leads to extrauterine pregnancy.