Check whether the fallopian tubes are open

The fallopian tube is an important organ for detecting female fertility. Only when a woman's fallopian tube is unobstructed and in normal condition can she conceive healthily. Therefore, there must be less inspection in this regard. So what methods can help us check whether our fallopian tubes are unobstructed and whether there is any blockage? Today we will introduce several of the most common methods so that you can understand them.

1. Fallopian tube permeability test

The fallopian tube permeability test involves injecting fluid into the uterine cavity through a catheter. The unobstructed nature of the fallopian tube is determined based on the resistance to injection, the presence or absence of reflux, the amount of fluid injected, and the patient's feelings.

【Operation steps】

1. Body position: Lithotomy position.

2. Disinfection: Routinely disinfect the vulva and vagina and place a vaginal dilator.

3. Explore the uterine cavity: Fix the anterior lip of the cervix with a cervical clamp, disinfect the cervical canal, and use the probe to explore the uterine cavity along the direction of the uterine cavity. After fixation, remove the vaginal speculum and cervical clamp.

4. Placement of uterine catheter: There are conical catheters, balloon catheters, etc. The placement method is slightly different depending on the type of catheter used: for placement of a conical catheter, the tip of the catheter is inserted along the direction of the uterine cavity, and the conical plug is tightly plugged into the cervical os. For placement of a balloon catheter, use long tweezers to clamp the front section of the balloon catheter (2 to 3 cm below the balloon), and send the tip of the catheter into the uterine cavity until the balloon passes over the internal cervical os or is located inside the cervical os. Connect the syringe to the air bag cavity of the double-lumen tube and slowly inject 2 to 3 ml of gas (liquid) to fix it.

5. Inject liquid: Connect the syringe to the end of the uterine catheter and slowly inject 20 to 50 ml of liquid.

2. Hysterosalpingography under X-ray

Hysterosalpingography under X-ray is a procedure in which contrast agent is injected into the uterine cavity and fallopian tubes through a catheter. The results are determined by the visualization of the contrast agent in the uterus, fallopian tubes, and pelvic cavity under X-ray fluoroscopy and radiography.

【Operation steps】

1. Body position: same as the fallopian tube permeability test;

2. Disinfection: Same as the fallopian tube permeability test;

3. Exploring the uterine cavity: Same as the fallopian tube permeability test;

4. Placement of uterine catheter: Same as fallopian tube permeability test;

5. Injection of contrast agent

6. Contrast imaging: First use fluoroscopy to observe whether there are any abnormal shadows in the pelvic cavity, then connect the syringe filled with contrast agent to the end of the uterine catheter, slowly inject the contrast agent under fluoroscopy, and take the first film when the uterus and fallopian tube are filled. Take the second tablet 10 to 15 minutes after taking the aqueous version and 24 hours after taking the oil version.

3. Ultrasound examination of uterus and fallopian tubes

Hysterosalpingography (HSUG) is simple, non-invasive and provides clear images. In the late 1980s, the ultrasound-assisted fallopian tube patency test attracted widespread attention from obstetricians and gynecologists as soon as it was proposed. By injecting normal saline into the uterine cavity and observing the fluid overflowing from the abdominal cavity, we can determine whether the fallopian tubes are unobstructed.

【Operation steps】

1. Body position: same as the fallopian tube permeability test;

2. Disinfection: Same as the fallopian tube permeability test;

3. Exploring the uterine cavity: Same as the fallopian tube permeability test;

4. Placement of uterine catheter: same as fallopian tube perfusion test;

5. Ultrasound scan: shows the uterus. Ultrasound of the adnexal areas and rectouterine pouch on both sides, paying attention to finding the best section to expose the uterine horns on both sides.

6. Injection and observation: Inject the liquid slowly and observe the condition of the uterine cavity. Pay attention to whether there is liquid flowing out of the two uterine horns and whether the amount of liquid in the rectouterine pouch increases.

4. Laparoscopy

Laparoscopic examination is performed under direct vision of the laparoscope. The dye solution is injected through a liquid-permeable uterine manipulator or double-lumen catheter to observe the flow of the dye solution in the fallopian tube and the overflow of the fimbria.

Laparoscopic examination plays an increasingly important role in the diagnosis and treatment of infertility. Many reproductive centers abroad list laparoscopy as a routine step in infertility diagnosis.