Molecular insights into salpingitis-induced infertility and ectopic pregnancy: pathogenesis, biomarkers, and translational perspectives

Abstract

Background: Salpingitis is a leading cause of female infertility and ectopic pregnancy worldwide. Despite advances in reproductive medicine, its early diagnosis and effective prevention of long-term sequelae remain challenging due to its often silent clinical course and complex pathogenesis. Objective: This review synthesizes current knowledge on the infectious, immunological, and molecular mechanisms underlying salpingitis, with an emphasis on diagnostic limitations and therapeutic challenges. Methods: A comprehensive evaluation of recent literature was conducted focusing on pathogen-induced inflammation, host immune responses, molecular signaling pathways, and emerging diagnostic and therapeutic strategies, including omics-based biomarkers and molecular imaging approaches. Results: Persistent inflammation, cytokine imbalance, and oxidative stress contribute to tubal scarring and ciliary dysfunction, ultimately leading to reproductive failure. While antibiotics are effective in treating acute infection, they do not prevent chronic complications. Advances in molecular diagnostics and non-invasive imaging show promise for early detection, although biomarker validation remains a major limitation. Rising antimicrobial resistance further complicates clinical management. Conclusion: Integrated approaches combining molecular diagnostics, imaging, and targeted therapies are essential to bridge laboratory research and clinical practice. Standardized diagnostic criteria, validated biomarkers, and improved reproductive health equity are critical to reducing the global burden of salpingitis.