Editing Ectopic pregnancy (section)

=== Tube damage ===
[[File:EUG 2.png|thumb|Left fallopian tube with an ectopic pregnancy in a 25-year-old woman after a [[salpingectomy]]]]
Tubal pregnancy is when the egg is [[Implantation (embryology)|implanted]] in the fallopian tubes. Hair-like [[Cilium|cilia]] located on the internal surface of the fallopian tubes carry the fertilized egg to the uterus. Fallopian cilia are sometimes seen in reduced numbers after an ectopic pregnancy, leading to a hypothesis that cilia damage in the fallopian tubes is likely to lead to an ectopic pregnancy.<ref name="Lyons">{{Cite journal |vauthors=Lyons RA, Saridogan E, Djahanbakhch O |year=2006 |title=The reproductive significance of human Fallopian tube cilia |journal=Human Reproduction Update |volume=12 |issue=4 |pages=363–72 |doi=10.1093/humupd/dml012 |pmid=16565155 |doi-access=free}}</ref> Women who smoke have a higher chance of an ectopic pregnancy in the fallopian tubes. Smoking leads to risk factors of damaging and destroying cilia.<ref name="Lyons" /> As cilia degenerate, the amount of time it takes for the fertilized egg to reach the uterus will increase. The fertilized egg, if it does not reach the uterus in time, will hatch from the non-adhesive [[zona pellucida]] and implant itself inside the fallopian tube, thus causing ectopic pregnancy.{{cn|date=September 2024}}

Women with pelvic inflammatory disease (PID) have a high occurrence of ectopic pregnancy.<ref name="Tay">{{Cite journal |vauthors=Tay JI, Moore J, Walker JJ |date=August 2000 |title=Ectopic pregnancy |journal=The Western Journal of Medicine |volume=173 |issue=2 |pages=131–4 |doi=10.1136/ewjm.173.2.131 |pmc=1071024 |pmid=10924442}}</ref> This results from the build-up of [[scar|scar tissue]] in the fallopian tubes, causing damage to the cilia.<ref name=speroff/> However, if both tubes were completely blocked, so that sperm and egg were physically unable to meet, then fertilization of the egg would naturally be impossible, and neither normal pregnancy nor ectopic pregnancy could occur. Intrauterine adhesions (IUA) present in [[Asherman's syndrome]] can cause ectopic cervical pregnancy or, if adhesions partially block access to the tubes via the [[Ostium of Fallopian tube|ostia]], ectopic tubal pregnancy.<ref name="Schenker">{{Cite journal |vauthors=Schenker JG, Margalioth EJ |date=May 1982 |title=Intrauterine adhesions: an updated appraisal |journal=Fertility and Sterility |volume=37 |issue=5 |pages=593–610 |doi=10.1016/S0015-0282(16)46268-0 |pmid=6281085 |doi-access=free}}</ref><ref name="Klyszejko">{{Cite journal |vauthors=Kłyszejko C, Bogucki J, Kłyszejko D, Ilnicki W, Donotek S, Koźma J |date=January 1987 |title=[Cervical pregnancy in Asherman's syndrome] |journal=Ginekologia Polska |volume=58 |issue=1 |pages=46–8 |pmid=3583040}}</ref><ref name="Dicker:">{{Cite journal |vauthors=Dicker D, Feldberg D, Samuel N, Goldman JA |date=January 1985 |title=Etiology of cervical pregnancy. Association with abortion, pelvic pathology, IUDs and Asherman's syndrome |journal=The Journal of Reproductive Medicine |volume=30 |issue=1 |pages=25–7 |pmid=4038744}}</ref> Asherman's syndrome usually occurs from intrauterine surgery, most commonly after [[Dilation and curettage|D&C]].<ref name="Schenker" />  Endometrial/pelvic/genital [[tuberculosis]], another cause of Asherman's syndrome, can also lead to ectopic pregnancy as infection may lead to tubal adhesions in addition to intrauterine adhesions.<ref name="Bukulmez">{{Cite journal |vauthors=Bukulmez O, Yarali H, Gurgan T |date=August 1999 |title=Total corporal synechiae due to tuberculosis carry a very poor prognosis following hysteroscopic synechialysis |journal=Human Reproduction |volume=14 |issue=8 |pages=1960–1 |doi=10.1093/humrep/14.8.1960 |pmid=10438408 |doi-access=free}}</ref>

Tubal ligation can predispose to ectopic pregnancy. Reversal of tubal sterilization ([[tubal reversal]]) carries a risk for ectopic pregnancy. This is higher if more destructive methods of tubal ligation (tubal cautery, partial removal of the tubes) have been used than less destructive methods (tubal clipping). A history of a tubal pregnancy increases the risk of future occurrences to about 10%.<ref name=speroff/> This risk is not reduced by removing the affected tube, even if the other tube appears normal. The best method for diagnosing this is to do an early ultrasound.{{cn|date=September 2024}}