One of the most common causes of infertility in women is a violation of the patency of the fallopian tubes. Specialists at the EMC Clinic for Reproductive and Prenatal Medicine in Moscow use modern methods for the diagnosis and treatment of tubal infertility.
The fallopian tubes are a paired organ located between the uterus and the ovary. In their lumen, an egg is fertilized by a sperm cell, and then the resulting embryo enters the uterine cavity. This happens due to the reduction of pipes and the movement of microregions lining the organ from the inside.
Any damage to the ciliated epithelium or fimbriae (villi at the end of the tube) can lead to the inability to fertilize or enter the embryo into the uterine cavity.
Obstruction can occur, among other things, due to the adhesive process in the pelvis. If the adhesions cover both the tubes and the ovary, tubal-peritoneal infertility is diagnosed.
An obstruction can be complete when the functionality of both pipes is disrupted along their entire length, or partial – the problem exists only in a certain section of the pipe.
In more rare cases, the causes of pathology are congenital anomalies and functional disorders. With functional obstruction, there is no interference and the passage of the canal is not reduced, but the movement of sperm and eggs does not occur.
Among the factors contributing to the development of pathology, it should be noted:
Infectious and inflammatory diseases of the genital organs.
Surgical procedures (abortions, operations for cysts, frozen pregnancies, appendicitis removal, etc.).
Endometriosis.
Past infections, surgeries, and inflammation contribute to the formation of adhesions and scars in the pelvis that block the lumen of the fallopian tube, and cilia may also become dysfunctional.
Tubal infertility often does not manifest itself in any way, there is no pain, discharge, so women may not be aware of the problem for a long time.
However, when fluid accumulates in the tubes (hydrosalpinx), periodic dull pulling pains in the lower abdomen (on the affected side) may occur.
If endometriosis is the cause of tubal obstruction, the pathology may manifest itself with painful menstruation, the appearance of spotting intermenstrual secretions and pain during intimate contact.
The EMC Reproduction Clinic uses a number of reliable and highly informative examination methods to diagnose tubal obstruction.:
Hysterosalpingography (HSG) is an X–ray examination using a special contrast agent inserted into the uterine cavity. X-rays taken after a certain period of time make it possible to detect the movement of matter through the pipes, assess structural disorders, and accurately determine the area of obstruction. The examination causes small spasms. At the request of the patient, it can be performed under anesthesia.
Echosalpingoscopy (SonoGSG) is an ultrasound examination of tubal patency. Through a special catheter, the uterine cavity is filled with sterile saline solution, and the doctor uses an ultrasound sensor to see whether the solution passes through the tubes or not.
Laparoscopy is a minimally invasive operation. After several micro-punctures in the navel area, a laparoscope equipped with a video camera is inserted into the abdominal cavity. During the examination, the specialist not only has the opportunity to assess the condition of the pipes, but also immediately carry out the necessary medical manipulations.
The examination method depends on the patient's medical history and is determined by the doctor individually in each situation.
Anti-inflammatory therapy with the possible use of physiotherapeutic methods (if an inflammatory process was detected during the diagnosis). It is advisable to do this if there is an acute inflammatory process at the moment.
Laparoscopic surgery. During the intervention, the doctor has the opportunity to immediately remove adhesions, fibroids, endometrioid foci, etc., restoring normal patency of the fallopian tube.
Surgery is indicated only in undetected cases, with partial obstruction, if there are no problems with fertility and ovulation, With complete obstruction, significant damage to the tube, fimbriae or ciliated epithelium - surgical treatment is ineffective. It is believed that fertility is preserved for 6 months after surgery. Further, the risk of new adhesions is high.
It is possible to achieve the onset of a long-awaited pregnancy with the help of in vitro fertilization (IVF), especially when the woman has already undergone surgical treatment.
Modern methods of reproductology make it possible to become pregnant even in the absence of fallopian tubes, since they do not affect the process of conception itself in any way. The egg is fertilized in a test tube, then the embryo is implanted into the uterus of the expectant mother.
Multidisciplinary approach to the problem – doctors of all necessary specialties can be involved in diagnosis and treatment – gynecologist, reproductologist, endocrinologist, oncologist, etc.
Our clinic's specialists have extensive experience in treating all types of infertility. Including trubny, using modern international protocols and the most effective methods in the arsenal: IVF with ICSI, IMSI. PIXIE, auxiliary hatch, etc.
Having your own bank of donor sperm, oocytes, and embryos.
Most of the specialists have experience working in the best foreign clinics and are regular participants in international conferences and seminars on reproduction and embryology.
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