Uterine Tube

Female Reproductive Anatomy, Source: National Cancer Institute.

The uterine (or fallopian) tubes are a pair of tubes found in the pelvic cavity of women. They run between the uterus and the ovaries, connecting the two structures. Approximately three to four inches long, the fallopian tubes are not directly attached to the ovaries. Instead, the tubes open up into the peritonial (abdominal) cavity, very close to the ovaries. The fallopian tubes play an important role in the process of conception.

Other Names

• Fallopian tube
• Oviduct
• Salpinx

Description

The uterine tubes are internal genital organs of the female genital system. The purpose of the fallopian tubes is to transport the egg (ovum) from the ovary, where it is made, to the uterus, where it can implant and begin a pregnancy. The egg is fertilized during its journey to the uterus. The fallopian tubes can be cut and sealed or clamped shut in a procedure known as tubal ligation. This procedure is a permanent form of birth control as it prevents fertilization.

Role of Uterine Tube in the Body

The fallopian tubes play an integral role in ovulation and conception. Without the fallopian tubes, the egg cannot become fertiziled and an embryo cannot reach the uterus for implantation.

How It Works

Anatomy of the female internal reproductive organs. 1. Ovary; 2. Medial surface; 3. Lateral surface; 4. Free border; 5. Mesovarial margin; 6. Tubal extremity; 7. Uterine extremity; 8. Oviduct (fallopian tube); 9. Opening of fallopian tube; 10. Infundibulum of fallopian tube; 11. Fimbriae of fallopian tube; 12. Ovarian fimbria; 13. Ampulla of fallopian tube; 14. Isthmus of fallopian tube; 15. Uterine part of fallopian tube; 16. Uterine opening of fallopian tube. Source: Seer's Training Website, Wikimedia Commons.

Once an egg has broken out of its follicle, it is released from the ovary. Using a set of finger-like projections, one of the fallopian tubes grabs hold of the egg. Once the egg has been pushed inside the tube, tiny hairs called cilia help to sweep the egg along, until it reaches the uterus.

The sperm will fertilize the egg inside of the fallopian tubes. At this point the egg and sperm become an embryo. This embryo continues to be guided through the fallopian tube until it reaches the uterus for implantation. This can take anywhere from a few hours to a few days. The fallopian tube contains a special lining to make sure that the embryo stays healthy during its trip.

Diseaes of the Uterine Tube

Conditions

There are a number of different problems that can develop with the fallopian tubes. These include tubal blockage and scarring which are typically caused by:

• Endometriosis: the growth of uterine tissue outside the uterus. This condition can cause blockage of the fallopian tubes.
• Pelvic Inflammatory Disease (PID): infection which may cause scarring of the fallopian tubes. These bands are called adhesions and consist of fibrous bands between tissue.
• Surgery of the abdomen or pelvis may cause scarring which may affect the fallopian tubes.
• Ectopic Pregnancy: a pregnancy which occurs within a fallopian tube. This condition may cause scarring and blockage of the tube and may require surgical removal of the affected fallopian tube.

The most significant complication of fallopian tube pathology is infertility. As many as one third of cases of infertility are a result of problems with the fallopian tubes. ^[1]

Cancer of the fallopian tubes is rare. The incidence of this type of cancer was 0.41 per 100,000 women in the United States from 1998 to 2003. ^[2] Most cancers which occur in the fallopian tubes have spread from other organs, usually the ovaries. The treatment and prognosis of fallopian cancer is similar to that of ovarian cancer. ^[3]

Procedures

In order to determine the cause and location of fallopian tube blockage, the following tests may be performed:

• A hysterosalpingogram (HSG) is a test used to determine if the fallopian tubes are blocked. Dye is injected into the uterus and through the fallopian tubes. An X-ray is taken which may show the location of the blockage. Occasionally, the injection of the dye corrects a blockage.

• Laparoscopic Surgery is sometimes performed in order to diagnose and treat tubal factor infertility. Laparoscopic surgery involves making a small incision in the abdomen. A small camera is then inserted into this incision, allowing the surgeon to view the fallopian tubes. Instruments can also be inserted through the incision, allowing removal of scar tissue and adhesions and possibly correction of a tube blockage.

Related Professions

Diseases of the fallopian tube are usually diagnosed and treated by a gynecologist. A gynecologist is a physician that specializes in diseases and conditions related to the female reproductive tract. The workup and treatment of infertility may be performed by a type of obstetrician/gynecologist known as a reproductive endocrinologist.

History

The fallopian tubes were named for Giuseppe Falloppio (1523-1562), an Italian anatomist and physician.

Research

Recent discoveries

• The factors which contribute to tubal infertility are discussed in a recent study. Specifically, the effect of Caesarean section delivery on tubal infertility (because of scarring) was evaluated and not found to be a significant contributing factor. ^[4]
• A new approach to tubal ligation using a hysteroscope rather than a laparascope appears to be an efficacious and less invasive option to permanent sterilization. ^[5]
• A leukemia inhibitory factor may be a factor in the increased rate of tubal pregnancy after salpingitis (infection of the fallopian tubes). ^[6]
• Ectopic pregnancy is reportedly twice as likely after in vitro fertilization (IVF) as with natural conception. The possible causes of this increase in incidence are discussed in a recent study. ^[7]

Current research

• There are a number of ongoing studies regarding the use of different chemotherapeutic agents in the treatment of gynecologic cancer, including fallopian tube cancer. A review of the studies is available here

References

1. ↑ Yang Y, Hao M, Zhu Y. Laparoscopic diagnosis of tubal infertility and fallopian tube lesions. Zhonghua Fu Chan Ke Za Zhi. 1996 Jun;31(6):327-9. Abstract
2. ↑ Stewart SL, Wike JM, Foster SL, Michaud F. The incidence of primary fallopian tube cancer in the United States. Gynecol Oncol. 2007 Dec;107(3):392-7. Epub 2007 Oct 24. Abstract
3. ↑ The University of Texas MD Anderson Cancer Center Web Site. Fallopian Tube Cancer
4. ↑ Saraswat L, Porter M, Bhattacharya S, Bhattacharya S. Caesarean section and tubal infertility: is there an association? Reprod Biomed Online. 2008 Aug;17(2):259-64. Abstract
5. ↑ Theroux R. The hysteroscopic approach to sterilization. J Obstet Gynecol Neonatal Nurs. 2008 May-Jun;37(3):356-60. Abstract
6. ↑ Ji YF, Chen LY, Xu KH, Yao JF, Shi YF. Locally elevated leukemia inhibitory factor in the inflamed fallopian tube resembles that found in tubal pregnancy. Fertil Steril. 2008 May 9. [Epub ahead of print] Abstract
7. ↑ Revel A, Ophir I, Koler M, Achache H, Prus D. Changing etiology of tubal pregnancy following IVF. Hum Reprod. 2008 Jun;23(6):1372-6. Epub 2008 Apr 1. Abstract

External Links

The American College of Obstetricians and Gynecologists

The American Society for Reproductive Medicine

U.S. Department of Health and Human Services: Women's Health.gov