Pelvic scarring, pelvic tubal adhesions and pelvic factor infertility
Page author Richard Sherbahn MD
Pelvic factor infertility accounts for about 25% of all cases of infertility.
This category includes cases in which the woman has difficulty conceiving and:
- completely blocked fallopian tubes - tubal factor infertility
- one blocked tube and one open tube
- tubal scarring (internal or external) or other tubal damage
- endometriosis causing infertility
- scar tissue or adhesions in the area of the tubes, ovaries or uterus
Pelvic scar tissue and adhesions is usually caused by pelvic infection, such as pelvic inflammatory disease (PID), or by pelvic endometriosis. Scar tissue can also be formed as a result of the normal healing process that occurs after pelvic surgery.
In cases with very minor scar tissue, it is not possible to be certain that this is the cause of the infertility problem. In general, the standard infertility testing is performed on all couples and if no other infertility causes are found, the presumptive diagnosis can be pelvic factor. However, if the degree of scarring is very minimal, a diagnosis of unexplained infertility may be more appropriate.
Close-up laparoscopic view of the area of the left tube and ovary in an infertile woman with severe pelvic scarring and adhesions. We are looking down into the pelvis from the upper abdomen. The space behind the uterus and above the rectum (R), at the lower right, is often referred to as the "cul-de-sac". A transparent band of adhesions between the ovary and the uterus and bowel is shown at "A".