1. What causes infertility?
I always say that having a child is a great system project. Just like a farmer who wants to grow a good farm, having a child also requires having sunlight, rain, earth, and seeds. That is to say.
① The female partner’s ovaries are producing normal mature eggs every month.
② The male partner is able to ejaculate and the semen contains normal number, shape and vitality of sperm.
③ the female partner’s fallopian tubes are open and unobstructed so that sperm and eggs can meet and fertilize in the tubes.
④ The fertilized egg must be able to pass through the fallopian tube into the uterine cavity and be able to implant itself in the endometrium. These are the four most basic conditions, one of which is missing. One of the most common causes of infertility is obstruction of the fallopian tubes.
2. What are the causes of tubal obstruction?
Tubal obstruction can be caused by developmental abnormalities, surgery (curettage) or inflammation inside or outside the fallopian tubes, foreign body obstruction, tuberculosis, etc. Inflammatory obstruction of the fallopian tubes is the most common cause of female infertility, accounting for about 50% of the infertility population. There are currently 50-80 million infertility patients worldwide. On average, one out of every eight couples of childbearing age in China faces confusion about fertility, and the infertility rate rises to 12%. With the spread of sexual diseases, early marriage, abortion and other reasons also maintain the trend of continuous increase, and gradually penetrate to the rural areas and grassroots.
3.How do I know that my fallopian tubes are blocked?
(1) Gynecological lavage test. Using pressure and total amount of lavage fluid to determine the patency of the fallopian tubes.
2) Ultrasound lavage to observe the speed of fluid passing through the fallopian tubes.
3) Tubal imaging, images to observe the patency of the fallopian tubes. This is the gold standard.
4.What kind of cases need tubal imaging?
A tubal examination should be done for couples who have been unsuccessful in normal conception for one year. Patients with previous ectopic pregnancy, multiple miscarriages, history of tuberculosis and pelvic inflammatory disease should have tubal imaging before pregnancy for their own sake.
5. The most important question for women is, is it painful to have an imaging?
It is uncomfortable, but not unpleasant; this is nothing to worry about. There are three reasons for this: the doctor’s technique is the degree of proficiency, the doctor’s responsibility is not from the perspective of caring for the patient, and the patient’s psychological impact of fear of the test. If you are very afraid, you can also use simple anesthesia.
6.What if the fallopian tube is narrow or not working?
The ultimate goal of ensuring tubal patency is to continue life …… so I take treatment to resolve tubal obstruction; maintain tubal patency; restore tubal function; and increase intrauterine pregnancy rate.
7.What are the specific treatment methods?
1）Uterine lavage; convenient, inexpensive, poor accuracy, unsatisfactory results for tubal occlusion formed by inflammatory adhesions or scarring.
(2) Gynecological surgery, which requires high equipment to restore the anatomical structure of the fallopian tubes, is costly and traumatic, and has inaccurate results in terms of functional recovery.
(3) Interventional recanalization, which is simple to perform, has a high success rate and few complications in the recanalization of proximal tubal obstruction and intraluminal adhesions; the rate of recanalization is high, but the effect is poor in distal tubal obstruction or pelvic adhesions.
(4) Laparoscopic surgery, which is more effective for middle and distal tubal obstruction and decomposition of pelvic adhesions, with higher cost and limited value for proximal tubal obstruction or intracavitary adhesions.
(5) Traditional Chinese medicine treatment has good effect on chronic inflammation and can promote the recovery of tubal function and increase pregnancy rate; the course of treatment is long and slow, and it is difficult to work for adhesions and obstruction in the tubal lumen.
(6) IVF, the ultimate treatment for infertility; difficult to operate, high cost, low success rate, prone to complications such as multiple pregnancy or ovarian hyperstimulation sign.
8.Pre-operative preparation and post-operative care of interventional treatment?
Pre-operative preparation is performed 3-7 days after the patient’s menstruation; preferably without gynecological inflammation. Postoperative care: general rest for 3-5 days, routine use of antibacterial agents and close observation of vaginal bleeding, abdominal pain, etc.; 2 postoperative uterine lavage, elective intercourse starting from the second menstrual cycle, and striving for pregnancy, with a follow-up of 12 months. The conception rate of patients who received interventional treatment in our hospital reached 50%.