Assisted Reproductive Technology and Tubal Factor Infertility
Summary
Assisted reproductive technology (ART) encompasses techniques such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) that overcome natural barriers to conception. Tubal factor infertility accounts for roughly a quarter of female infertility and arises from damage or obstruction of the fallopian tubes. Common causes include pelvic inflammatory disease, endometriosis and previous surgery, which may lead to hydrosalpinx, adhesions or tubal occlusion. Such pathologies can disrupt gamete transport, alter the endometrial environment through toxic fluid reflux and provoke chronic inflammation, all of which impair embryo implantation. Surgical management—ranging from salpingectomy to proximal tubal occlusion—aims to restore uterine receptivity or prevent deleterious tubal secretions, while ART offers alternative routes to bypass tubal impediments. Contemporary research focuses on refining diagnostic accuracy, understanding molecular mechanisms of endometrial impairment and comparing surgical strategies to optimise ovarian response and live birth rates. Improving non‐invasive diagnostics and tailoring intervention according to individual ovarian reserve and tubal pathology remain key to enhancing global access to fertility care and maximising ART success.
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Assisted Reproductive Technology and Tubal Factor Infertility publication trend
The graph below shows the total number of articles in assisted reproductive technology and tubal factor infertility across all publications each year (not limited to Nature Index journals).
Technical terms
Assisted Reproductive Technology (ART): Clinical procedures, including IVF and ICSI, to achieve pregnancy by handling oocytes and sperm outside the body.
Hydrosalpinx: Fluid-filled distension of the fallopian tube often due to inflammation or obstruction, negatively impacting endometrial receptivity.
Salpingectomy: Surgical removal of one or both fallopian tubes to eliminate deleterious tubal secretions before ART.
Proximal Tubal Occlusion (PTO): Surgical or mechanical blockage of the proximal segment of the fallopian tube to prevent fluid reflux without removing the tube.
Transvaginal Sonography (TVS): Ultrasound imaging via the vaginal canal to assess pelvic structures including the fallopian tubes non-invasively.
References
- Proteomic Profiling Identifies Candidate Diagnostic Biomarkers of Hydrosalpinx in Endometrial Fluid: A Pilot Study. International Journal of Molecular Sciences (2024).
- Transvaginal Ultrasound Accuracy in the Hydrosalpinx Diagnosis: A Systematic Review and Meta-Analysis. Diagnostics (2023).
- Ovarian Response, Pregnancy Outcomes, and Complications Between Salpingectomy and Proximal Tubal Occlusion in Hydrosalpinx Patients Before in vitro Fertilization: A Meta-Analysis. Frontiers in Surgery (2022).
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