Can hysteroscopy check the fallopian tubes?

Most women with cervical diseases need to undergo hysteroscopy. This examination is very routine and can specifically see what is wrong with the female body. Especially for some infertile women, it is likely that infertility is caused by problems with the fallopian tubes, because blockage of the fallopian tubes will cause the egg to be discharged. So can hysteroscopy check the fallopian tubes?

The diagnosis and treatment of infertility summarizes the "four-step examination method", which is:

(1) Male semen routine

(2) Female pelvic examination (commonly known as gynecological examination)

(3) Female ovulation monitoring (including ovarian function assessment)

(4) Check the patency of the fallopian tube.

The fallopian tube examination is arranged at the last step. Why is that?

1. Since the first three items are non-invasive examinations and relatively simple and easy to perform, they are arranged first. The fallopian tube patency test is an invasive examination with the risk of infection, so it is arranged as the last step.

2. If any of the first three examinations (including male semen routine examination, female gynecological examination, ovarian function and ovulation function) is abnormal, there are corresponding follow-up treatment plans. If it is primary infertility and there are no high-risk factors for fallopian tube obstruction, such as a history of acute pelvic inflammatory disease, a history of pelvic surgery, a history of purulent appendicitis perforation, etc., treatment can be tried temporarily for a period of time without the need for fallopian tube examination, which will only increase the pain and risk of surgery.

Depending on the infertility factors, whether it is necessary to check the patency of the fallopian tubes and the timing of the examination may vary.

1. Male oligospermia

If the man has severe oligoasthenospermia, he needs to undergo ICSI treatment directly without the need for fallopian tube examination. If the man has mild oligoasthenospermia and the woman has no obvious abnormalities in ovulation and ovarian reserve function, a fallopian tube examination can be performed. If the fallopian tubes are unobstructed, intrauterine insemination (IUI) can be used to assist pregnancy.

2. Female ovulation disorder

If the female has ovulation disorders, especially primary infertility, and there is no abnormality in the ovarian reserve function and the male's semen, she should be given ovulation induction treatment first. If ovulation occurs after 3 to 6 cycles but conception has not occurred, a fallopian tube patency check can be performed.

3. Endometriosis in women

After a gynecological examination of the woman, combined with a history of dysmenorrhea and ultrasound examination, if she is suspected of having pelvic endometriosis, ovarian cysts, or other diseases that affect fertility, laparoscopy and treatment should be the first choice.