Today, the problem of infertility is quite common. Examinations usually begin after a year of regular unprotected sex, which did not lead to pregnancy. A couple who have encountered such a problem, sooner or later raises the question of how to check the patency of the fallopian tubes so that it is as reliable and safe as possible.
According to statistics, in half of cases the problem of infertility occurs due to the fault of the woman. Examining men is much easier, so they begin with them. As a rule, the spouse passes tests for infection and a spermogram.
Examining a woman is more difficult, since there are many factors that affect fertility. The problem may be hormonal imbalance leading to a lack of ovulation.
The culprit of infertility is sometimes the endometrium, in which the implantation of the embryo does not occur. This is possible due to chronic endometritis, adenomyosis, and a number of other diseases.
It happens that spouses face a cervical factor of infertility. In this case, sperm can not get from the vagina into the uterus. Because cervical mucus becomes an obstacle for them.
However, after the exclusion of all these factors, the woman and the doctor are usually interested in how to check the patency of the fallopian tubes. Typically, this study is the last to be performed due to complexity.
Such an informative, safe and popular research method as a conventional ultrasound is not suitable for this. Since the size of the fallopian tubes is very small, they are not visualized. On ultrasound, they can be seen only in acute inflammation, when they significantly increase.
Meanwhile, the tubal factor of infertility is the most common. In Russia, about 4 million families are not able to have a child precisely for this reason.
The ways to check the patency of the fallopian tubes are as follows:
- hysterosalpingography or metrosalpingography;
- diagnostic laparoscopy;
- pneumopertubation;
- hydropertubation;
- echo-hysterosalpingoscopy or sonosalpingography;
- office hysteroscopy.
These methods differ from each other in reliability, safety, complexity and cost. Doctors have different opinions on the best.
Therefore, how to determine the patency of the fallopian tubes, the gynecologist and the patient decide together. The most common method is hysterosalpingography.
During this study, a special substance is injected into the uterus and an x-ray is taken. If the pipes are passable, then it shows how the drug is poured into the abdominal cavity.
However, the reaction to the introduction of the substance may be a spasm, which will give a false negative result. To avoid this, it is recommended that you take two no-shpa tablets before the test.
Hysterosalpingography as well as other manipulations should be carried out only in the absence of inflammation. To do this, smears are given before the study. Otherwise, a complication of the procedure can be extensive inflammation.
Another disadvantage of this procedure is the irradiation of the pelvic organs. In the cycle in which the study is conducted, it is necessary to protect yourself, even if pregnancy has not occurred for a long time. Many gynecologists believe that after hysterosalpingography, the likelihood of conception increases due to the washing effect.
More gentle, but less informative is sonosalpingography. An ultrasound is used instead of an X-ray, and physiological saline is injected into the uterus.
Pneumo-and hydropertubations are rarely used now, as some gynecologists believe that they stretch the pipes. These methods consist of introducing air and a solution (respectively) under pressure into the uterus.
The most informative method is laparoscopy, which from a diagnostic study can go into medical manipulation. The cause of obstruction is adhesions due to inflammation, surgery, and endometriosis. If pathology data are detected during laparoscopy, they can be deleted immediately.
Today, such operations are very common, they are more sparing than ordinary. With laparoscopy, three small incisions are made through which the instrument is inserted, including a camera that allows you to examine the uterus, ovaries, tubes and monitor the progress of the operation. It is performed under general anesthesia. After this manipulation, therapy is indicated to prevent the formation of adhesions.
With office hysteroscopy , a flexible hysteroscope is inserted through the vagina through the vagina, at the end of which there is a camera. It allows you to examine the cervical canal, uterus, tubes and under its control to carry out the necessary manipulations.
Thus, a woman chooses how to check the patency of the fallopian tubes in consultation with a doctor. Currently, there are several ways to do this. They differ in information content, price, probability of complications.