Case presentation: Xiao Wang has not been pregnant for five years after marriage and was examined for bilateral tubal obstruction. I planned to give up conservative treatment and go for tubal lysis. After inquiring, I learned that there is a laparoscopic tubal lysis with good treatment effect. She came to a tertiary care hospital with high hopes and asked to undergo the procedure. However, after examination, she was told that the tubal blockage and adhesions were very serious and she was not suitable for laparoscopic tubal lysis and IVF was recommended. Undeterred, she suspected that the big hospital had too many patients and deliberately pushed the commission, or wanted to earn big money for IVF, so she went to another district hospital. The doctors at this hospital did not stand in her way and admitted her for laparoscopic tubal lysis. Six months after the operation, Wang found out she was pregnant! She was so excited and thankful that she did not give up the operation so easily. However, when she was 50 days pregnant, she developed abdominal pain. When she went to the hospital and asked for birth control, the doctor told her to have an ultrasound first. She was worried that the ultrasound might damage the fetus, so she did not follow the doctor’s advice and took Chinese medicine to keep the fetus on her own. Two days later, instead of relieving the abdominal pain, it continued to worsen and she fainted when she went to the toilet. Her family rushed her to the hospital, where she was diagnosed to have ruptured ectopic pregnancy with hemorrhage and blood accumulation in the abdominal cavity amounting to 1000 ml. …… Case review For patients with tubal infertility, the laparoscopic tubal evacuation treatment developed in recent years has good therapeutic effect and has a certain pregnancy rate after treatment. Laparoscopy can accurately examine the condition of the pelvic cavity, especially the adhesions around the fallopian tubes, ovaries and ovaries and other diseases in the pelvic cavity, and can understand the severity of the lesions and the extent of their involvement, and has absolute advantages in releasing pelvic adhesions and restoring the morphology of the fallopian tubes. This is complemented by hysteroscopic tubal lysis for better results. However, once the structure and function of the fallopian tubes are severely damaged, even if the tubal lumen is barely unblocked, its function cannot be reversed, no matter what advanced treatment is used. Because surgery can barely unblock a severely diseased tubal lumen, it cannot change the severe structural and functional damage to the tubal lining and the adhesions of the peri-tubal tissues caused by inflammation or other pathologies, so the anatomical reopening of the fallopian tubes is not equal to the restoration of their normal transport function. Clinically, it has been found that in cases with severe tubal pathology, especially in those with stiffened and thickened tubal walls, destroyed mucosa, dense and extensive adhesions or severe fluid accumulation, even if laparoscopic adhesiolysis + lysis is completed with difficulty, fertility may not be restored, but may lead to an increased incidence of ectopic pregnancy. Therefore, if you are told that you are not suitable for lysis treatment because of severe tubal lesions, do not take any chances to avoid life-threatening ectopic pregnancy. At present, the common method of initial evaluation of tubal function in China is hysterosalpingography, and the gynecologist will choose whether or not it is appropriate to perform lysis based on the results of the imaging. Usually, for those who have mild tubal lesions and normal wall morphology, de-fertilization is recommended and the function of the fallopian tubes can be restored after de-fertilization treatment; on the other hand, for those who have severe obstruction of the tubal lumen, stiff walls and severe adhesions with the surrounding area, IVF is recommended.