How to check the patency of the fallopian tubes in women ?

tubal patency plays a great importance for the fertilization process.

These anatomical structures are moving away from the bottom of the uterus and are suitable to the gate of the ovary.For the fallopian tubes is characterized by peristalsis, which is directed to the body of the uterus.

This allows you to move the egg, which appeared after ovulation in the abdominal cavity, in the direction of the uterus.It is in the fallopian tube, and there is its follow-up meeting with the sperm, ie fertilization.Therefore, if a violation of patency of tubes, it is broken and fertile women function.In this article we look at how to check the patency of the fallopian tubes, and how to prepare.

Fallopian tubes and their cross-


Fallopian tubes extend on either side of the uterus.They consist of several sections, with adherent to the ovaries fimbrial department.Its structure facilitates capture egg leaving the ovary in the middle of the menstrual cycle.

Then the egg moves through the fallopian tube.If you get the
sperm in the female genital tract increases the likelihood of fertilization.However, if the increased enzyme activity of the ovum, it can not be implanted in the uterus, which should be omitted, and the tube with the development of ectopic pregnancy.

Last usually interrupted at time of 7-8 weeks, as in the fallopian tube are no conditions for the normal development of the pregnancy.Thus, the permeability of the fallopian tubes is a key factor in the onset of pregnancy.Otherwise developing tubal-peritoneal infertility, which after endocrine (anovulatory) takes the second place in the overall structure.

Causes of obstruction of the fallopian tubes


main causes obstruction of the fallopian tubes are as follows:

  • inflammation (salpingo)
  • adhesions after surgery on the pelvic organs
  • congenital hypoplasia of the fallopian tubes
  • treatment of ectopicpregnancy.
Therefore, every time the question of surgical intervention, an obstetrician-gynecologist assesses its validity.A timely treatment of inflammation of the fallopian tubes is the key to saving women's reproductive functions.The same holds true for the treatment of ectopic pregnancy.

The sooner it is diagnosed (in the early stages of development to its spontaneous abortion), the higher the probability of organ-preserving treatment.For large size of the ovum or with intraperitoneal bleeding on the background of this pathology has been held for the removal of the tube in order to save a woman's life.

obstruction of the fallopian tubes can be either unilateral or bilateral.In the last chances of pregnancy are sharply limited, that is an indication for the use of assisted reproductive technologies.

Methods for evaluation of tubal patency


Rate tubal patency is necessary when carried out a thorough examination of the woman at the impossibility of conceiving.

Standard infertile couples survey program includes:

  1. 1) Ovulation Estimation (held or ultrasound in dynamics or hormonal research)
  2. 2) Evaluation of tubal patency by various methods
  3. 3) Semen - studycellular composition and quality of sperm in compliance with all the rules of collection (abstinence for 2 days, quick transport to the laboratory, the use of a special container, etc.).
Currently, evaluation of tubal patency following methods:

  • hysterosalpingography - X-ray examination
  • ehogisterosalpingografiya - ultrasound
  • laparoscopy as the last step, which can also pursue and therapeutic target (cross-recovery pipes).

Laparoscopy


Check patency of the fallopian tubes using laparoscopy - a medical diagnostic procedure.For its implementation introduced special equipment through the three holes in the abdominal wall, creating a pre-pneumoperitoneum (introduction of gas into the abdominal cavity).

The image is on the screen at a higher magnification, allowing you to precisely assess the condition of the uterus and appendages, and undertake appropriate therapeutic manipulation.However, due to the invasiveness of laparoscopy is performed as the last diagnostic test.

Surgery is performed under anesthesia.Most Viewed general anesthesia with shutting down of consciousness.Applying this purpose spinal anesthesia limited as injected into the abdominal cavity gas gives respiratory function.

So before laparoscopy is required to assess the extent of anesthetic risk.And if it's high, then as the first stage of treatment can be used pertubatsiyu, ie the introduction of gas into the fallopian tubes, which will restore the minor violation of their patency.

Hysterosalpingography


Check patency of the fallopian tubes using hysterosalpingography - this X-ray evaluation of the state of the uterus and fallopian tubes.For it requires the introduction of radiopaque substance into the uterine cavity.To this end, the cervix is ​​necessary to fix the bullet forceps, which is accompanied by certain painful sensations.

Moreover, another drawback of this study is to hit the radiopaque substance into the abdominal cavity and the subsequent development of adhesions.Also, after the investigation has pain of varying severity, which is itself stopped by for a few days.It is associated with the presence of contrast in the fallopian tubes, increasing the pressure therein.Therefore hysterosalpingography replaced by a more advanced ultrasound technique, devoid of these shortcomings.

However, during the hysterosalpingography has one advantage - obtaining X-ray images, which exclude subjective assessment diagnostician.This makes it possible to evaluate the results of treatment over time, comparing the images with each other.But too often repeated carrying out hysterosalpingography is not recommended because of the radiation exposure.

Interpretation of results is based on the following principles:

  • whether the uterine cavity deformation is available and what is its condition
  • entered if the contrast into the peritoneal cavity or not
  • visualization of the fallopian tubes, in this case may be determined by their ampoule-shaped extension to the lack of contrastin the pelvis (this indicates a complete obstruction).

Ehogisterosalpingografiya (US)


Ehogisterosalpingografiya is a modern method of diagnostics of a condition of the fallopian tubes.The essence of the method is as follows:

  • introduction of saline into the uterus through a special catheter
  • assessment of its status as a liquid is a good acoustic environment
  • estimate of the fluid entering the peritoneal cavity.
ehogisterosalpingografiya The technique is more advanced compared to hysterosalpingography.

Its main advantages are:

  1. 1) Absence of reflex spasm of the fallopian tubes, which can lead to false positive results related to the obstruction of the fallopian tubes.This is due to the fact that there is no moment of the cervix using a bullet fixation forceps for introducing the solution into the uterine cavity.
  2. 2) Almost complete painless procedure
  3. 3) Ability to conduct research in the dynamics, since there is no radiation exposure as an X-ray examination.
In conclusion, it should be noted that the fallopian tubes are taking a direct part in the process of fertilization.Therefore, their obstruction leads to the development tuboperitoneal infertility with all the attendant health and social consequences.

Timely diagnosis of this condition at an early stage (before the development of rough scarring) allow for effective treatment and give the woman a chance to get pregnant.


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