Before trying to conceive, women of childbearing age should make preparations, especially those who have suffered from adnexitis or have a history of miscarriage, and should know in detail about the patency of the fallopian tubes. The consequences of ectopic pregnancy are often very serious, ranging from damage to the fallopian tubes, which may require repair or removal, to life-threatening consequences. According to foreign statistics, 82.4% of ectopic pregnancies are caused by poorly functioning fallopian tubes, so treatment of poorly functioning fallopian tubes is the key to preventing ectopic pregnancies. Due to a variety of factors, many patients have gone into many misunderstandings in the treatment process of tubal incompetence. 1, simply drug oral, drug enema or physiotherapy to treat tubal laxity. About 82.4% of tubal incompetence is caused by infectious inflammation of the fallopian tubes. Infectious inflammation is often transient and short-term. Almost 100% of the tubal adhesions caused by inflammation are permanent, and almost 100% of the tubal incompetence is found in the post-marital infertility examination, when and what caused the tubal adhesions has become a historical headless case, and anti-inflammatory treatment during this period is too late to mend the fold. The only anti-inflammatory treatment and medication available is during the acute tubal inflammation period. Of course, short-term medication after the tubes have been unblocked is very important, as the surrounding tissues are often in a state of inflammation, congestion and edema, which can easily lead to adhesions and obstruction again. The use of gentamicin, dexamethasone, chymotrypsin, salvia, ozone and other medications while the tubes are unblocked can promote local tissue blood circulation, enhance local tissue repair, reduce re-adhesion of the tubes and keep the tubes open. The drug enema and physiotherapy can only improve the local blood circulation, but the treatment of partial obstruction of the fallopian tubes caused by fibrous tissue adhesions in the abdominal cavity can only be a boot rubbing, which is unlikely to produce any therapeutic effect. 2. Repeated lavage to treat tubal obstruction. Because of the advantages of simple equipment, easy operation and low price, tubal lavage was commonly used before the 80s. However, in clinical practice, it was found that the misdiagnosis rate of this method was as high as 50% or more, and it could not determine the site of tubal obstruction, nor could it clarify the severity and nature of tubal obstruction, and there was a risk of tubal rupture and haemorrhage as in ectopic pregnancy. Because this method is blind, it is impossible to understand the patency of the fallopian tubes under direct vision, and can only be used to analyze and judge whether the tubes are open or not based on the surgeon’s direct sensation, which is often unreliable due to various factors, resulting in a misdiagnosis rate of more than 50% for the diagnosis of patency of the fallopian tubes. In patients with tubal umbilical blockage, because the luminal layer of the tubal umbilicus is very thin, the fluid injected through the uterine catheter during the lavage process accumulates in the umbilicus of the tubes bilaterally, and there is no resistance during the fluid injection. This examination method has now been abandoned in hospitals where it is available, and all tubal lavage examinations have been replaced by trans-x-ray hysterosalpingography. In some hospitals and clinics with poor conditions, tubal lavage is still used as a test for tubal patency, and some patients have been repeatedly lavaged in several hospitals, which not only does not help in treating tubal incompetence or incompetence, but also easily induces new infections, making the already incompetent tubes “worse”. The unreliability of the tubal lavage test is sometimes not due to irresponsibility on the part of the doctor, but rather to the limitations of the test itself. The tubal lavage test is often based on the patient’s sensation of whether or not it hurts, and the doctor’s own sensation of whether or not there is resistance to determine whether or not the fallopian tubes are open. It is not known that if the patient is nervous, tubal spasm etc. can cause pain during lavage; the operating doctor cannot feel much resistance when the umbilical ends of the tubes are obstructed bilaterally. 3. Some hospitals often use laparoscopy, hysteroscopy for tubal intubation and lavage or combined hysteropelvic surgery for the treatment of tubal incompetence. Laparoscopy for treatment of tubal patency: In recent years, with the massive application of obstetrical and gynecological endoscopy, new methods have been provided for tubal patency examination, including laparoscopic direct vision tubal lavage examination, hysteroscopic intubation lavage test through the tubal opening and combined laparoscopic and hysteroscopic examination, tuboscopy and other methods. Since endoscopic surgery requires high instrumentation, laparoscopy is still an invasive surgery and can only understand whether the fallopian tubes are patent and the obstruction at the umbilical end of the fallopian tubes and the adhesions around the fallopian tubes, and there is no way to understand the specific blockage or the site and nature of the poorly patent fallopian tubes. At the same time, the conception rate after laparoscopy has been low, which may be related to thermal injury and requires vigilance! Hysteroscopy is mainly an examination method used to understand the internal situation of the uterine cavity, which can clearly understand the microscopic lesions in the uterine cavity under direct vision through the combination of cold light source and endoscope, and is a microscopic examination, but there is no way to understand the situation outside the uterine cavity. As a result, the chances of tubal perforation due to blind insertion and blind passage are significantly increased, and more serious damage and adverse consequences may occur as the perforation cannot be detected in time. The combined hysteroscopy and laparoscopy to check the patency of the fallopian tubes also has great limitations, because hysteroscopy can only understand the internal situation of the uterus, while laparoscopy can only understand the specific situation in the abdominal cavity and the tissue structure around the fallopian tubes and the presence of adhesions, i.e., the blockage of adhesions at the umbilical end of the fallopian tubes and the effect of adhesions around the fallopian tubes on the peristaltic function of the fallopian tubes, i.e., through these two methods, we can only understand the peristaltic function of the fallopian tubes. In other words, by these two methods, we can only understand the situation in and around the two ends of the fallopian tubes, but not the specific location and nature of the tubal lumen that is not open. Since we do not know the site and nature of the obstruction in the tubal lumen, we cannot talk about the efficacy of the treatment. Since the narrowing of the tubal lumen cannot be observed or experienced during the tubal reintubation process, it is only a kind of blind insertion and blind passage, therefore, there is no way to detect the inappropriate or excessive insertion in time and the chance of tubal perforation due to blind insertion and blind passage increases significantly. The risk of more serious damage and adverse consequences is significantly increased. It is only useful for the treatment of incomplete obstruction of the umbilical end of the fallopian tube. 4. Since tubal incompetence is the main cause of ectopic pregnancy, it is believed that IVF can avoid the occurrence of ectopic pregnancy. With the development of reproductive medicine and the emergence of IVF, more and more infertility patients, and even some medical professionals, take IVF as the first choice for infertility treatment and abandon basic diagnosis and treatment, which is not only economically costly but also may cause serious complications such as ovarian hyperstimulation syndrome, and most hospitals highly recommend this technique due to the drive of economic interests. In fact, most infertility cases can be resolved at mid-level hospitals at a relatively low cost. The widespread use of IVF technology has led many medical units to neglect the control of the relevant indications, resulting in a waste of medical resources on the one hand, while greatly increasing the economic burden on patients, and inevitably triggering complications that should not have occurred by conventional treatment of infertility on the other. With the advancement of national accreditation and strengthening of management, it is believed that this situation will be controlled to some extent. IVF is one of the assisted reproductive technology methods, which involves fertilizing sperm and eggs in a test tube, i.e., in vitro fertilization, and then transferring the embryonic precursor – the fertilized egg – into the woman’s uterus and developing it into a fetus, commonly known as IVF because it is fertilized in a test tube. “IVF is not always successful in every treatment cycle. Currently, our domestic success rate is about 30%. Complications such as ovarian hyperstimulation syndrome, multiple pregnancies, anesthesia accidents, and ectopic pregnancies can occur. Medical data indicates that the likelihood of ectopic pregnancy in IVF is 5-8%. This is because the embryo is placed in the uterus on the third day after fertilization and is injected into the uterine cavity through a transfer tube, which is the same as the hysterosalpingography and fluidization for tubal patency test. There is no way to prevent ectopic pregnancy from occurring during IVF, and the only reliable way is to remove both fallopian tubes or to embolize them. To get out of the misunderstanding of the treatment of tubal incompetence, the treatment of tubal incompetence should be based on the specific site, nature and degree of tubal incompetence of each patient to choose the corresponding treatment plan – that is, the best plan is the personalized treatment plan. For example, laparoscopic release of peri-fallopian tube adhesions can be performed for tubal incompetence caused by peri-fallopian tube adhesions. For proximal blockage of the fallopian tubes or tubal incompetence, selective tubal cannulography (SSG) and recanalization (FTR) are the treatment options. Selective tubal cannulation and recanalization is performed under high-definition X-ray fluoroscopy, and then a guide wire is used to separate the adhesions at the specific site of proximal tubal patency or obstruction according to the selective tubal angiography. The catheter is then injected with medical ozone and contrast agent to further separate the adhesions, and then injected sequentially with drugs to prevent adhesions. In this operation, the specific part of the proximal tube that is incompetent or obstructed is accurately targeted under direct X-ray vision for direct separation of adhesions by guidewire, and the catheter is placed directly on the part of the tube that is partially adherent for contrast and adhesion release, and anti-adhesion medication is injected at the same time under pressure, because the pressure generated by the fluid solution on the local part of the tubal adhesions is greater, the separation effect on the tubal adhesions is stronger, so that the tubal The chances and degree of restoration of patency caused by the proximal part of the isthmus are far more unique than those of other methods. This method has become the treatment of choice for tubal incompetence due to the proximal end of the tubal lumen. Selective tubal insertion and recanalization is performed under X-ray fluoroscopy, which is intuitive and allows the surgeon and the patient’s family to observe the entire procedure clearly at a glance. It is less painful, minimally invasive, takes more than 30 minutes to complete, and can be performed on a walk-in basis. The correct diagnosis rate of tubal obstruction is almost 100%, and the incidence of ectopic pregnancy due to tubal failure can be greatly reduced after the successful recanalization of tubal failure caused by the narrowing of the proximal part of the isthmus. The procedure is performed without anesthesia, thus avoiding the medical risks that may arise from anesthesia accidents. It is the most effective examination and treatment method to avoid and reduce the incidence of recurrent ectopic pregnancy and to resolve tubal incompetence within the scope of indications. For the treatment of tubal incompetence and mild adhesions at the umbilical end, interventional unblocking together with local ozone therapy is effective, and even some patients with hydrosalpinx can be unblocking.