Infertility related to other tubal and uterine anomalies

Absolute fallopian tubal blockage is an indication for in-vitro fertilisation (IVF) because tubal unblocking and surgery are rarely successful. The presence of hydrosalpinges seen on ultrasound is an indication for salpingectomy because fluid from diseased tubes may affect a replaced embryo. Reversal of tubal ligation only results in a live birth in about 50% of cases, but success rates fall in those older than 40 years; assisted reproductive technology (ART) may be required.

Intrauterine adhesions (detected by hysteroscopy) can affect fertility. Although rare, they may occur following dilatation and curettage, miscarriage, or extrapulmonary tuberculosis. The extent of adhesions predicts the outcomes of fertility treatment; severe intrauterine scarring (severe Asherman syndrome) has a particularly poor outcome. Hysteroscopic removal of adhesions has variable outcomes.

Subserosal fibroids are not thought to cause infertility, but submucous fibroids or those impacting the endometrium should be evaluated by a specialist; myomectomy may be required.