Which condition is a known contributor to tubal transport problems besides chronic PID?

• A. Ruptured appendix
• B. Endometriosis
• C. Ovarian cyst
• D. Fibroids

Answer: (A)

Tubal transport depends on patency and proper fimbrial function, and endometriosis is a major contributor to its disruption. Pelvic endometriosis creates a chronic inflammatory environment that promotes adhesions around the fallopian tubes and ovaries, distorting pelvic anatomy and often fixing or narrowing the fimbrial end. These changes can hinder the capture of the oocyte, impede movement into the tube, or affect tubal motility and ciliary function, all of which reduce the likelihood of successful transport of the ovum to the uterus. Although a ruptured appendix can lead to pelvic adhesions via peritoneal infection, it is not classically described as a primary cause of tubal transport impairment in the way endometriosis is. Ovarian cysts and fibroids influence fertility mainly through hormonal effects or uterine environment, rather than direct tubal transport disruption.