Obstruction of the fallopian tubes can lead to infertility. The cause of such a violation can be inflammation of the pelvic organs, both acute and chronic, various forms of genital endometriosis, operations, both on the pelvic organs and on the organs of the abdominal cavity.
Methods for testing obstruction of the fallopian tubes
Echogasterosalpingoscopy
During this procedure, 20-40 ml of sterile fiz. Are injected into the uterine cavity. solution (a 5% solution of glucose, but better polyglucin). Passage of the introduced solution through the fallopian tubes is examined by means of ultrasonic scanning. Scanning takes place on a natural scale. Sterile solution that poured into the uterine cavity, in its degree of "transparency" is significantly distinguished among surrounding tissues, which allows using ultrasound to compare the density of the solution and the contents of the bladder (the bladder is filled during the examination):
- If the patency of the fallopian tubes is two-sided, the solution will be located to the left and right of the uterine section line, after which it will merge into the utero-rectal cavity into one whole.
- If obstruction is observed in the ampullary parts of the fallopian tubes, the sterile solution is located in the fallopian tubes in the form of retort-like cavity formations.
- If after introduction of the solution the fallopian tubes are not visible, but the uterine cavity has increased due to the injected solution, then it can be said about the occlusion of the interstitial parts of the fallopian tubes.
- If the fallopian tubes are viewed for two cm (no more), this signals an occlusion of the isthmic part of the fallopian tubes.
- If the solution is not visible in the utero-rectal cavity, then this indicates the presence of occlusion of the fallopian tubes of arbitrary localization.
Hysterosalpingography (GHA)
This method of diagnosis is usually carried out on the fifth to the ninth day of the menstrual cycle (GHA is performed if the cycle is twenty-eight days). If a woman who has infertility plans pregnancy, then it is impossible to exclude pregnancy in the second phase of the cycle, as in the middle of the cycle, and carrying out the procedure can cause a violation of the natural process. If a woman is prevented from pregnancy, the GHA can be performed on any day of the cycle, except for menstruation days. Before the woman goes to the GHA, she passes tests for syphilis, HIV, hepatitis C and B. Also, a woman takes a smear to flora to make sure that the vaginal microflora is normal.
The procedure is performed on an outpatient basis, usually without the use of pain medications. Contrast substance is injected into the cervix and if everything is normal, the uterine cavity, as well as the uterine tubes, will be filled with this substance and will flow out of the unoccupied fimbrial ends. An X-ray is taken at this moment, only so you can see the cavity of the fallopian tubes and uterus. The procedure uses water-soluble contrast substances - verografine, triombrast.
Hysterosalpingogram decoding
- If only the uterine cavity is seen, then we can talk about the obstruction of the interstitial areas of the fallopian tubes.
- If the uterine tubes and uterus are viewed, the first ones for two centimeters (no more), then we can talk about the obstruction of the isthmic sections of the fallopian tubes.
- If the fallopian tubes are visible all over - the impassability of the ampullar sections of the fallopian tubes. In addition, the fallopian tubes can be widened unevenly. If there is an obstruction of the isthmic, interstitial or ampullar areas in the abdominal cavity, there is no contrast solution.
Laparoscopy with chromohydrobubation
When carrying out laparoscopy, the patency of the fallopian tubes is checked. For this purpose, a liquid (methylene blue solution) is introduced into the cavity through the cervix of the uterus. The passage of the liquid through the fallopian tubes is controlled by the camera (it is also being intervened) in the present-day mode. The diagnostic value in assessing the patency or obstruction of the fallopian tubes by laparoscopy is usually 100%. Laparoscopy will detect the level of damage and eliminate the cause of this condition.