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Infertility

Scarring in Fallopian Tubes

03/05/1997

Question:

Can an infection in the Fallopian tubes cause scarring in less than 3 months. I always thought scarring could occur after a lengthy infection. Is there a time standard? If you do have scarring, what tests can show this? Can a sonogram? And what impact does scarring have on sterility?

Answer:

Significant scarring of the fallopian tubes can occur after a brief infection lasting only days. In reality the infection usually occurs for a longer period of time, but the symptoms usually only appear for days. These infections called pelvic inflammatory diseases are a significant cause of infertility problems. After one episode of documented PID (I say documented, because a lot of women are given the diagnosis for any amount of pelvic pain) there exists a 12% chance of infertility, after two, a 25% chance. Many women have had tubal scarring infections that have come and gone without any symptoms. These are usually discovered during a workup for the cause of infertility. A sonogram is a poor test to determine scarring. The more definitive tests are a laparoscopy (where the tubes are directly visualized by placing a scope in the abdomen in the operating room) or hysterosalpingography (injecting dye into the uterus and taking x-rays to look at the outline of the tubes). Both have significant risks and can cause more problems, therefore they should be done only after a period of infertility is documented and other causes have been ruled out by less invasive tests. There is no reason to undergo either of these tests to satisfy curiosity when infertility hasn't been a problem.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated