Which combination best describes common causes of tubal transport problems?

• A. Chronic PID
• B. Ruptured appendix
• C. Abdominal surgery
• D. Chronic PID and ruptured appendix or abdominal surgery

Answer: (D)

Tubal transport depends on open, patent fallopian tubes with smooth lining and coordinated movements to allow the egg and sperm to meet and move along the tube. Chronic pelvic inflammatory disease causes ongoing inflammation of the tubes, leading to scarring, fibrosis, and narrowing (salpingitis). This damage can block the lumen or disrupt ciliary function, making transport unreliable or impossible. Pelvic inflammation from a ruptured appendix or from abdominal surgery often leads to pelvic adhesions—bands of scar tissue that bind the tubes to surrounding structures or kink them. These adhesions distort anatomy and hinder the tubes’ ability to move contents through them. When both processes are present, the combination of tubal scarring and adhesions provides a robust explanation for tubal transport problems, which is why that option is the best answer.