Tubal examination is the basic test to diagnose infertility. The main tests for the patency and function of the fallopian tubes are: tubal patency test (hydrosalping), uterine tubal iodography, hysteroscopic tubal patency test, ultrasound tubal patency test, vaultoscopy and tuboscopy, etc. The most accurate method for testing the patency and function of the fallopian tubes is currently considered to be iodine oil imaging.
Basic principles of hysterosalpingography
A contrast tube is inserted through the cervix into the uterine cavity and the contrast agent is injected through the cervix under X-ray fluoroscopy to observe the contrast agent in the uterus and fallopian tubes. If the contrast agent is iodized oil, an abdominal plain film should be taken 24 hours later to observe the diffuse distribution of the contrast agent in the pelvis and to analyze the morphology and function of the uterus, fallopian tubes and pelvis.
Indications
Hysterosalpingography with iodine oil is suitable for those patients who suspect infertility due to tubal incompetence. Hysterosalpingography should be performed if there is a previous history of abortion and uterine manipulation, a history of suspected pelvic inflammatory disease, and if other causes of infertility have not been found.
If you have never been pregnant, have not had your husband’s semen examined, and do not yet have the criteria for an infertility diagnosis, imaging should not be the first option.
If you have an acute pelvic infection or an infection elsewhere in your body (such as a toothache), you should not have an imaging test.
There are two types of contrast agents: oil (40% iodinated oil) and aqueous (6% pantothenic glucosamine or other aqueous contrast agents). A large number of clinical data confirm that oil contrast can better show the patency and function of the fallopian tubes and has a certain quality effect, and the postoperative pregnancy rate is significantly higher than water-based contrast, which is the most widely used contrast agent with the highest diagnostic value in clinical practice.
Its disadvantages and complications
1. There is sometimes a possibility of false negative when the fallopian tubes are not visualized at all. In other words, sometimes when the fallopian tubes are not visualized at all, it does not necessarily prove that the tubes are not working.
2. In patients with a history of pelvic inflammatory disease, there is a 3% chance of inducing acute pelvic inflammatory disease.
3.If the oil agent accidentally enters the parametrial vessels or iliac vessels and forms a thrombus, there is a risk of acute pulmonary embolism, but it is very rare.
4. Some people have allergic reactions to iodine oil preparations.
None of these complications should be taken lightly.
Method of imaging
1.Appointment
In order to reduce the disturbance of endometrial thickness, we usually schedule the imaging between 3-5 days after menstrual cleansing. Please come to the hospital one day in advance to make an appointment for examination, and the doctor will prepare for you at that time. Before the imaging, you need to do a white belt test, blood routine and coagulation analysis.
2. Iodine allergy test
Before the imaging, the doctor will put a small amount of iodine oil on your conjunctiva and observe for 25-30 minutes to see if the conjunctiva becomes red and swollen.
3.Imaging
The imaging is performed under the X-ray machine. The doctor places the tube in your uterine cavity in the operating room and accompanies you to the radiology department. After 24 hours, you will have to go to the radiology department for an abdominal plain film to observe the diffusion of the iodine oil in the pelvic cavity.
You will get a formal report on the 2nd day.
4.Consultation
When you come to the assisted reproduction clinic, please bring your x-ray films with you so that the doctor can make treatment recommendations to you based on the x-ray films and referring to the radiology report.
Precautions after surgery
1.No intercourse in this cycle to prevent infection and avoid pregnancy.
2.You can take some oral antibiotics to prevent infection.
3.You can stop contraception in the 2nd month and try to get pregnant.
4.Earlier, ask the doctor of reproductive center to consult and make a pregnancy or treatment plan.