In a typical menstrual cycle, once the follicles reach maturity, the luteinizing hormone (LH) surge occurs, which causes ovulation 36 hours later. The egg is ovulated into the end of the fallopian tube and travels to the distal end where fertilization occurs. Any condition that impedes, or blocks, egg transport through the tubes can cause tubal factor infertility. In many of these cases in vitro fertilization (IVF) is the treatment of first choice.

Sometimes endometriosis will attach to the fallopian tubes causing scarring and/or adhesions "on" the tubes, leading to obstruction. In addition, severe pelvic infections (pelvic inflammatory disease, PID), caused by a variety of microorganisms including Chlamydia, can severely damage the fallopian tubes.

In other cases, women who previously had their tubes tied, seek to have the procedure reversed. While this is sometimes possible, tubal sterilization should be considered a permanent form of birth control.