A history of salpingitis (inflammation of the fallopian tubes) is associated with the highest relative risk of infertility. Approximately one-third of women presenting for infertility evaluation will exhibit signs and symptoms indicative of problems due to uterine or fallopian tube abnormalities. Blocked or damaged fallopian tubes may reduce fertility by preventing sperm from reaching the ovum or by preventing the egg from reaching the uterus. Tubal infertility may also arise after septic abortion, infection following childbirth (puerperal sepsis), peritonitis or following abdominal surgery. Infertility caused by some of these factors is partly preventable; an uncomplicated appendectomy does not increase the risk of a subsequent tubal blockage, whereas a ruptured appendix causes a 5-fold increase in such risk. Tubal infertility can sometimes be treated by surgery, but if this is not possible, or if surgery is unsuccessful, IVF may be the solution. Tubal surgery is a major procedure involving a general anesthetic and often lasts for several hours. The operation is usually carried out with the aid of an operating microscope. Surgery is successful in about 45% of patients when the obstruction is at the uterine end of the tubes, but only in 20-25% when obstruction is at the fimbrial ends of the tubes, closest to the ovaries. After most types of tubal surgery, there is an increased risk of subsequent ectopic pregnancy.

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