In recent years, tubal obstruction has become a major cause of secondary infertility due to increased surgical operations such as abortion. Repeated pelvic infections, including pelvic inflammatory disease and adnexitis, can cause tubal inflammation, tubal scar contracture, wall hardening, thickening and multiple intra-luminal adhesions and fibrosis, resulting in tubal obstruction, causing primary or secondary infertility, accounting for about 30% to 40% of the causes of infertility. With the development of gynecological endoscopy and interventional treatment, patients with tubal infertility can generally be effectively diagnosed and treated. Wang Yanjun, Department of Obstetrics and Gynecology, Panzhihua Hospital of Integrative Medicine Traditional lavage has a certain effect on tubal recanalization, but the cure rate and pregnancy rate are low because the tubal pressure obtained during lavage is very small and it is difficult for therapeutic drugs to enter the tubes, and it is impossible to determine whether the tubes are unilateral or bilateral, so it is blind. Hysteroscopy is by far a more advanced and minimally invasive procedure. Under the direct view of the TV screen, the morphology of the uterine cavity and the opening of the fallopian tubes can be seen, and the severity and extent of the lesions can be understood, polyps and adhesions caused by inflammation can be excluded, and after performing corrective surgery as appropriate, tubal pressure lavage can be performed, and drugs can be injected directly from the endopian tube under pressure. This procedure can overcome the shortcomings of traditional lavage, and can also separate and unblock some adhesions and mild to moderate obstruction, so the efficacy is certain. The fertility experts pointed out that the catheter inserted into the interstitial part of the fallopian tube only plays a direct role in unblocking the proximal part of the tubal obstruction in the horn of the uterus and the interstitial part, and the effect on the distal lesions is not satisfactory. However, the structural and functional damage to the fallopian tubes cannot be reversed due to severe inflammation and other factors, and the adhesions around the fallopian tubes cannot be released by hysteroscopic tubal lavage. Therefore, it is recommended that tubal intubation should not be performed in patients with severe tubal obstruction, rigid walls or extensive dense adhesions around the fallopian tubes. The postoperative treatment with the addition of Chinese herbal medicine and preserved enema can precisely make up for the above deficiencies. Chinese herbal formulas have the function of activating blood circulation, eliminating blood stasis, improving blood circulation, promoting tissue softening, loosening adhesions, regulating endocrine and improving immunity. After preserved enema treatment, the drugs are absorbed through the rectum and can easily reach the lesions, improve local microcirculation in the pelvis, improve the internal environment of the uterine tubes, soften the hardened and fibrotic tubes and restore their functions, thus increasing the recanalization rate of the tubes and postoperative conception rate. The combination of hysteroscopic tubal intubation and Chinese and Western medicine in the treatment of tubal obstructive infertility has proven to be more effective. Hysteroscopic tubal lavage is usually chosen to be performed within one week after menstrual cleansing. If it is too early, the endometrium is not fully repaired or there is residual menstrual blood, and it is easy to inject menstrual blood into the abdominal cavity; if it is too late, if the luteal phase is lavaged, the endometrium is thicker, and if a metal head is used, it is easy to damage the endometrium and bring the endometrium into the abdominal cavity. In addition, if acute abdominal pain occurs during hysteroscopic tubal lavage, attention should be paid to whether there is tubal rupture. Generally, in cases of tubal incompetence, when more than 10 ml of fluid is injected, there is a feeling of lower abdominal distension and pain, but when the pressure is relaxed and the fluid flows back into the syringe, the pain disappears, unlike tubal rupture. The operation is performed close to the menstrual period and the endometrium is easy to be exfoliated and injected into the abdominal cavity. Long-term postoperative follow-up should be performed to see if there is endometriosis. Intercourse and bathing are prohibited for 2 weeks after surgery. Warm tip: Hysteroscopy can simultaneously detect uterine factors that can cause infertility such as uterine polyps, uterine adhesions and other lesions, and give appropriate treatment at the same time as the examination. Although the tubal factor is an important factor causing infertility, the uterine cavity factor should not be ignored. For larger uterine cavity abnormalities, such as larger polyps, submucosal fibroids and longitudinal uterine septum, preoperative ultrasound can mostly screen them out, while smaller uterine cavity lesions, such as small uterine cavity polyps or abnormal endometrial hyperplasia and uterine cavity adhesions, are easily missed by ultrasound and can be detected by hysteroscopy and can be treated at the same time. For distal tubal obstruction caused by pelvic inflammation and adhesions, combined hysterolaparoscopic surgery is the best choice.