Tubal subfertility

Patent fallopian tubes are a prerequisite for normal human fertility. However, patency alone is not enough—normal function is crucial. Although patients often view them as either open or “blocked,” the fallopian tubes are highly specialised organs. They have a critical role in picking up eggs and transporting eggs, sperm, and the embryo. The fallopian tubes are also needed for sperm capacitation and egg fertilisation. Because the egg is fertilised in the fallopian tubes and the first stages of development of the embryo occur during its four day journey to the uterine cavity, the tubes are also important in nutrition and development. The fallopian tubes are vulnerable to infection and surgical damage, which may impair function by affecting the delicate fimbriae or the highly specialised endosalpinx. A fallopian tube obstruction occurs in 12% to 33% of infertile couples,1 and so tubal patency should be investigated early.