Cervico-utero-tubal factors in infertility.

Infertility is a common medical problem resulting from one or more defects in the reproductive tract. Of the known causes of infertility, cervico-utero-tubal factors are important because they are generally manageable. Cervical factors include changes in cervical architecture, mucus, or both, resulting in a hostile environment through which sperm must pass. Assessment of this factor includes an evaluation of the cervical mucus both as a transport medium for sperm and as a diagnostic indicator of pending ovulation. Uterine factors include congenital defects and benign tumors resulting in a distorted endometrial surface or a reduced cavitary volume. Surgical reconstruction is of benefit in some cases when other causes of infertility or pregnancy wastage have been effectively managed or ruled out. Tubal factors are among the most common infertility factors and until recently, have only been managed by major invasive surgery. Recently, better assessment of factors leading to tubal obstruction and less invasive tuboplasty or tubal recanalization procedures offer new hope in future management.