When an infertile couple seeks medical treatment, after the doctor understands that there are no abnormalities in the man’s semen and the woman’s genital structure, he or she will generally recommend that the woman do a fallopian tube patency test to find out whether the fallopian tubes are unobstructed. The following inspection methods are available:
(1) Fallopian tube ventilation test: This test is performed by The cavity is inflated and connected with a manometer to determine whether the fallopian tube is open by measuring the pressure in the uterine cavity. If the fallopian tube is blocked, the manometer will show high pressure; if it is clear and air flows into the abdominal cavity through the fallopian tube, the manometer will show low pressure. Since this method is complex, not very accurate, and has certain risks, most hospitals no longer use it.
(2) Fallopian tube canalization: This method is simple and easy to perform, and it is currently the most commonly used Methods. This test injects liquid into the uterine cavity. If more than 20 ml of liquid can be injected smoothly and without resistance, and the subject does not feel abdominal distension, pain or discomfort, and there is no reflux of liquid, it means that the fallopian tube is unobstructed. On the contrary, if there is resistance during the injection or the injection cannot be continued after injecting 3 to 5 ml, the patient feels swelling pain, and there is a lot of refluxed liquid, it means that the fallopian tube is blocked. However, infertile women must pay attention to the following issues when undergoing this examination: ① Do not have sexual intercourse after menstruation is clear in the month of the examination; ② Go to the hospital for examination within 3 to 7 days after menstruation is clear; ③ Acute inflammation of the reproductive tract , such as trichomonal vaginitis, candida vaginitis and endometritis, etc., must be cured before undergoing examination; ④ Do not undergo examination when the fever exceeds 37.5°C; ⑤ Do not be nervous during the examination to avoid muscle spasm It will affect the examination results and cause false impressions; ⑥ Before the examination, antispasmodics or sedatives can be injected to eliminate false impressions; ⑦ During the examination, do not touch the cloth towels laid by the doctor on the vulva and abdomen with your hands, because these cloth towels have been sterilized. There are bacteria on your hands. If the sterilized cloth is contaminated, it will cause inflammation if the bacteria are brought into the uterus. You should also be careful not to touch the examination table where the doctor\’s sterilized instruments are used; 8. You cannot draw a conclusion after one failure. You must check multiple times or cooperate with other inspection methods before drawing a conclusion.
(3) Uterine cavityFallopian tube lipiodol angiography:Although fallopian tube canalization is the most commonly used examination method, this method is sometimes inaccurate. For example, sometimes it is mistaken for fallopian tube obstruction due to muscle spasms and inability to inject fluids. In addition, since there are two fallopian tubes, if one is blocked and the other is unobstructed, the liquid can be injected smoothly, so it is impossible to determine which one is unobstructed and which one is blocked. Lipiodol angiography can make up for the shortcomings of the fluid penetration test. Lipiodol angiography generally uses 40% lipiodol, and an iodine allergy test is done before surgery. Those with negative stroma will go to the radiology department, where a doctor will perform the procedure (the method is the same as the fluid penetration test, but instead of water, iodized oil will be injected), the development of the uterus and fallopian tubes will be observed under X-ray fluoroscopy and films will be taken. On the fluorescent screen, you can clearly see which fallopian tube is open, which one is blocked, and where the obstruction is. Women undergoing this test need to pay attention to the same issues as fallopian tube canalization. However, it should be noted that on the morning of the second day of the examination, after flushing the remaining iodized oil in the vagina, go to the radiology department to take X-rays to see whether there is iodized oil overflowing into the abdominal cavity, and to further determine whether the fallopian tube is unobstructed.
(4) B-type ultrasound examination:This method combines fallopian tube canalization with B-type ultrasound Ultrasound is combined, and while injecting fluid, the B-ultrasound screen displays the accumulation of fluid in the uterus and fallopian tube cavity and whether there is an increase in fluid in the abdominal cavity to determine whether the fallopian tube is unobstructed. Hydrogen peroxide can also be used instead of ordinary liquids for this test.
(5) Laparoscopy: Laparoscopy is to make 2 to 3 small incisions in the abdomen. A surgical procedure that makes an incision. One incision is usually made near the belly button, and if additional incisions are needed, usually above the pubic hair line. In order to observe the organs around the pelvis, including the fallopian tubes and the outside of the uterus, the surgeon will insert an extremely thin observation instrument, a laparoscope, through the first incision. Laparoscopy allows the surgeon to see clearly whether the fallopian tubes are normal and whether the fallopian tube fimbria are present and moving normally. The shape and appearance of the fallopian tubes can indicate whether disease is present or if the tubes are blocked. Inflammation or scarring anywhere in the fallopian tubes may change its appearance. Furthermore, laparoscopy can detect the presence and severity of endometriosis and adhesions. During laparoscopic surgery, general anesthesia is required. For better observation, carbon dioxide is usually injected into the abdomen, which separates the abdominal wall, intestines, and reproductive organs. A short, narrow tube called a trocar is placed into each incision to serve as an entry point for the laparoscope and other instruments. The light on the laparoscope serves as illumination. If necessary, during abdominal exploration, surgery can also be performed at the same time. For example, adhesions can be separated, misplaced endometrial tissue can be removed, and some of these can also be removed.Tissue samples. With surgery like laparoscopy, it can be done with just the first incision, but sometimes a second smaller incision is needed. Before the trocar is removed at the end of the surgery, the carbon dioxide can be discharged. In fact, most of the carbon dioxide has been discharged, and the remainder is slowly absorbed by the body. Any trapped air can move upward causing pain around the shoulder. After the operation, the incision is wrapped with a small bandage, and after a short recovery period, the patient can be discharged from the hospital. After returning home, patients should wear the same clothes they wore in the hospital with a loose waistband, as this will avoid exacerbating any abdominal discomfort. When to go to work depends on work needs. There will be some discomfort for 2 to 3 days after surgery, sometimes lasting for a week. So, try to relax as much as possible during this week. Although patients may plan to have laparoscopic surgery again on Thursday or Friday so that they can rest over the weekend, they should be prepared to feel more tired than usual in the days ahead due to the effects of anesthesia. Prepare. In the past, laparoscopy was considered a routine procedure, but now it is only used in individual cases after the risks and benefits have been weighed by the patient and physician. Generally, doctors will consider laparoscopic surgery when the following conditions occur: a history of pelvic infection, abnormal hysterosalpingography, symptoms of endometriosis, and some unexplained infertility.
(6) Hysteroscopy: This process can replace hysterosalpingography to detect uterine fibroids , polyps or scar tissue. It is not a good choice for examining the fallopian tubes. A hysteroscope is a thin, telescopic instrument like a laparoscope, but it is inserted into the patient\’s uterus through the cervix. A hysteroscope gives a good view of the inside of the uterus and the openings of the fallopian tubes, but it can cause uterine cramping and pain. Sometimes, for a more thorough examination, doctors will recommend performing laparoscopy at the same time as hysteroscopy. When only hysteroscopy is performed, the patient does not need to be anesthetized, but if both tests are performed, the patient must be under general anesthesia.
Generally speaking, doctors choose fallopian tube canalization first, and then proceed to uterine fallopian tube lipiodol angiography when in doubt. If you are unclear or have other conditions that need to be understood, choose B-mode ultrasound, laparoscopy or hysteroscopy.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao