Almost every woman wants to hear the cherished “mother” from her son or daughter. However, for a number of reasons this is not possible. And one of these is poor patency of the fallopian tubes (which is popularly referred to as oviducts), which can lead to undesirable consequences like tubal pregnancy or infertility. To determine the exact causes of this phenomenon, the woman is sent by a gynecologist for a special examination.
What is it, what is it for, and how can the problem go away - read in this article. But first, consider the probable causes of this kind of pathology.
What could be the reason?
As you know, under normal conditions, a mature egg leaves the ovary and begins its journey through the fallopian tube, in which cilia, covering the entire inner surface of the epithelium, help it. Here she hopes to meet with a male reproductive cell, resulting in fertilization.
The cells begin to divide, an embryo is formed, which, with good patency of the fallopian tubes, reaches the uterine cavity for some time, where it is fixed to the endometrial wall. But under certain circumstances, the patency of the fallopian tubes can be changed, and then the course of pregnancy in normal mode is impossible.
The female reproductive organ, called the uterus, is the only cavity where the full development of the fetus is possible. The possibility of successful conception and bearing a child depends entirely on the health of this organ and the condition of the fallopian tubes themselves.
According to specialists in the field of infertility research, 30-40% of the total number of registered cases is associated with obstruction of the fallopian tubes. The reasons for the appearance of this pathology, prompting a check of the patency of the fallopian tubes, may be different. First of all, this:
- The course of inflammation caused by the activity of trapped bacteria.
- Sexually transmitted diseases like gonorrhea, chlamydia, trichomoniasis, genital herpes and a number of other infections.
- Gynecological operations, including possible complications after them.
- Abortion
- Surgery to treat diseases of the abdominal cavity and pelvic organs - appendicitis, peritonitis.
- The presence of diseases of the reproductive system - salpingitis, sactosalpinx, endometriosis, uterine fibroids.
Another cause of deviations in the structure of the fallopian tubes, including their complete or partial absence, is an innate feature of the body. In addition, another reason for checking the patency of the fallopian tubes can be various strong stressful situations or hormonal imbalances, only this happens extremely rarely.
Effective diagnostic techniques
In order to make a diagnosis of infertility disappointing for most women or, conversely, to refute it, specialists need to understand why this phenomenon is caused. Then appropriate treatment will be prescribed.
As medical practice shows, many women learn about the presence of any inflammatory process at random during the diagnosis. In this regard, you should not refuse from routine gynecological examinations, which must be done every 6 months.
How do they diagnose patency of the fallopian tubes and what is the procedure called? For this, different methods are used, each of which has its own advantages and disadvantages. Proven for years, the methods are painful and, in addition, require lengthy clinical studies. In addition, they are carried out only using general anesthesia. As for modern techniques, they are relatively painless; general anesthesia is not required in this case.
The following diagnostics are currently available:
- Hydrosonography.
- Laparoscopy.
- Hysterosalpingography.
In order for a woman to choose the most suitable type of study, she needs to consult a gynecologist in order to obtain a gynecological history. And depending on this information, the doctor will advise the best option for diagnosis.
The so-called testimony
There are a number of characteristic signs, the presence of which allows a woman to think about the need to study the patency of the fallopian tubes. These include the following manifestations:
- The menstrual cycle has become irregular or has completely stopped.
- Expected pregnancy does not occur for more than 6 months.
- The inflammatory processes of the appendages are regular or acquire a chronic stage.
- The presence of infectious diseases that are sexually transmitted.
- Pain in the lower abdomen.
All these signs clearly indicate that undesirable processes are occurring in the female body. Therefore, it is better to be safe again by visiting a doctor. In addition, it is not possible to independently verify the condition of the fallopian tubes, since for this just can not do without special equipment.
Ultrasound of patency of the fallopian tubes
The patency of the fallopian tubes can be checked without resorting to a high dose of x-ray radiation. An ultrasound machine comes into play, in which the reliability of the study is up to 90%. And in our time, several measurements are available: these are 2D, 3D and even 4D. In addition to the name hydrosonography, such a technique has another name - echosalpingography (echohydrotubation).
The method is simple to implement, the study is carried out directly in the office. To visually confirm or refute the diagnosis, the examination is carried out in two ways:
- Through the wall of the abdominal cavity.
- Transvaginally - through a special sensor that is inserted into the vagina.
During the ultrasound of the patency of the fallopian tubes, it all depends on the qualifications of the operator who controls the device and its ability to correctly interpret the images taken. The procedure is performed in the period from the 5th to the 20th day of the menstrual cycle, but experts still recommend contacting no later than the 8th-11th day, since the time of ovulation is closest to this period. In this case, the probability of cramping is minimal, it is easier to inject the concentrate.
During the diagnosis, a woman may have unpleasant sensations, which is a disadvantage of this type of study. In addition, contraceptive measures must be observed before the procedure.
Laparoscopy
Many women are interested not in what the procedure for patency of the fallopian tubes is called, but how it is performed. Specifically, this diagnosis relates to the surgical method, which is characterized by minimal damage to the skin. During the procedure, you can not only establish the fact of obstruction, but also eliminate the cause of “blockage”.
To carry out this kind of operation, stationary conditions are necessary. On the surface of the skin of the abdominal wall, several small incisions are made. Subsequently, an optical system equipped with micro-illuminators and a manipulator is introduced through them. In order to improve visual observation, the abdominal cavity is filled with carbon dioxide.
To assess the degree of patency of the fallopian tubes, an aqueous solution of methylene blue is injected into the uterus, and a special video camera allows you to see if this substance passes through them. Moreover, the diagnosis is carried out, as they say, in real time.
Since such a diagnosis requires surgical intervention, albeit to a small extent, a recovery period is necessary after it. Fortunately, in this case it passes quickly and usually takes from two to three days, no more.
Among all available diagnostic methods, laparoscopy is the most accurate technique, which is not inferior to either hysterosalpingography or ultrasound. In addition, the risk of adhesions is the lowest.
GHA
Hysterosalpingography of the fallopian tubes is carried out by radiography. You can:
- Determine the degree of pipe passability.
- Detect the presence of deformity of the genital organ or appendages.
- Assess the condition of the endometrium.
- Identify any pathological changes.
The study is best done before ovulation in the follicular phase of the menstrual cycle. In this case, there is no need for anesthesia, and the procedure itself is performed on an outpatient basis.
Everything is done as follows. A contrasting special substance is introduced into the cavity of the genital organ through a cervical canal through a catheter. Then x-rays are taken at the initial and final stages of the study. And according to them, the results of GHA fallopian tubes are evaluated.
The first image allows you to evaluate the shape of the uterine cavity, determine the clarity of the contours, and also identify possible pathological changes in the tubes, including the degree of patency. Thanks to the second picture, you can see the spread of contrast medium in the pelvic area, if, of course, it enters there.
If you compare this diagnosis with laparoscopy, then it is less accurate (only 80%). At the same time, it is well tolerated by women, despite the unpleasantness of the entire procedure. In this case, it is very important that there are no inflammatory processes. Let us dwell in more detail on this type of diagnosis and consider many features.
Preparation for GHA fallopian tubes
If a woman was prescribed hysterosalpingography (or GHA, in a simple way), she needs to prepare for this procedure properly. For some reason, many doctors forget to warn patients that the procedure is rather painful and can cause a lot of discomfort. In this connection, good moral preparation is needed.
Before conducting a study, a woman should have fresh urine and blood tests on her hands. You may also need a gynecological smear and scrapings of the cervix and cervical canal. In addition, it is possible that tests will be needed for the presence of STDs (HIV, TORCH infections).
A number of necessary requirements should also be fulfilled:
- A day or two before the GHA procedure, refrain from sexual contact.
- For a week, do not carry out douching procedures and abandon any kind of intimate hygiene products.
- Also, do not use any kind of medicine like vaginal suppositories, tablets, sprays for a week. Unless it is caused by the need for hysterosalpingography, on the advice of a doctor.
Another question that may arise in relation to GHA of the fallopian tubes: on what day of the cycle is this procedure performed? As a rule, this is the period when menstruation ends, while ovulation has not yet occurred. It is during this period of time that the condition of the endometrium allows the presence of endometriosis to be detected.
On the day of the procedure, a woman needs to empty her intestines through an enema or laxative. And just before the start of the GHA, it is worth visiting the restroom. It does not hurt to take a sedative, which will allow uterine contractions not to interfere with the procedure itself.
When the hysterosalpingography is completed, a contrast medium and blood may flow out within a few days (usually 1-3 days). Therefore, in the hospital it is worth taking swabs, pads or using disposable underwear.
Contraindications to the GHA
The main medical indication for the procedure is a preliminary diagnosis - infertility. It is very important to carry out a number of additional examinations before the GHA of the fallopian tubes, blood or urine tests, since there are contraindications to the procedure, which include:
- The fact of pregnancy.
- Allergic predisposition of the body to a contrast drug.
- The presence of diseases of the reproductive system of an infectious nature.
For this reason, before conducting the GHA procedure, analyzes and some other studies are needed.
Consequences and Complications
As a rule, such a diagnostic procedure as hysterosalpingography is safe for a woman, and after her there are no serious consequences or complications. However, it is impossible to completely eliminate any side effects. This is an allergic reaction to a contrast drug, which is extremely rare. In addition, allergic manifestations can occur in the presence of bronchial asthma.
Complications after GHA fallopian tubes can be early or late. Early complications include, in addition to allergies:
- Vascular reflux, when the contrast agent enters the capillaries or veins of the genital organ.
- Lymphatic reflux: the fluid already enters the lymphatic network of the uterus.
- Perforation of the uterine wall is through damage caused by the careless actions of medical personnel.
- Pipe burst if too much pressure is applied.
Complications of a late nature include inflammatory reactions that occur due to infection during the procedure, again due to careless actions on the part of medical staff.
What the GHA results show
Based on the pictures taken, the specialist can proceed to their analysis. The result is evaluated by the degree of distribution of the contrast medium in the internal organs of the female body. If it is noticeable that it penetrated into the fallopian tube from the uterus, and from there into the circulatory system, this indicates their good patency.
In addition to the fact that during this diagnosis it is possible to judge the degree of patency of the oviducts, one can also find a number of pathological changes that directly affect the health status of the female body and serve as a serious obstacle to the conception of a child. These include:
- polyps;
- benign neoplasms in the form of uterine fibroids;
- commissures;
- hydrosalpinx and a number of other cases.
Despite the fact that determining the degree of patency of the fallopian tubes through hysterosalpingography in medicine has been used for many years, the results are not always very accurate. And this is even with the correct procedure. The accuracy of the results is evaluated by two criteria: sensitivity and specificity.
Where can I get the GHA?
Currently, women can go to public or private clinics to diagnose the condition of the fallopian tubes, where there is usually a wide range of services. A few decades ago, confirmation of infertility for a woman was a terrible diagnosis, which simply put an end to the possibility of becoming pregnant. But thanks to the achievements of modern medicine, it is no longer a problem to restore the functionality of the fallopian tubes.
In addition to the question of where GHA of the fallopian tubes are done, every woman is also interested in the price of the procedure. It depends on the type of diagnosis, the degree of accuracy of the results, as well as the possible risks of complications.