tubal obstructive infertility
Introduction
Introduction to tubal obstruction infertility Pregnancy is a very complicated process. It requires the sperm eggs to form a fertilized egg, and finally implants in the uterine cavity. In addition to having normal sperm, eggs and proper uterine environment, it is also an important part of pregnancy to enable sperm and eggs to meet and transport to the uterine cavity. This task is done by the fallopian tubes. The fallopian tube is not only a channel connecting the ovary and the uterus, but also has the functions of ovulation, egg storage, insemination, providing a combination of sperm and eggs, and transporting the pregnant egg to the palace to promptly reach the endometrium of the official cavity. If the fallopian tube has inflammation, resulting in blockage of the fallopian tube, sperm can not pass the infertility caused by the encounter with the egg, it is called fallopian tube obstruction infertility. basic knowledge The proportion of illness: 0.04% - 0.07% Susceptible people: women Mode of infection: non-infectious Complications: abortion, puerperal infection
Cause
Tubal obstructive infertility
Tubal mucosal adhesions (30%):
Chronic salpingitis is a disease caused by infertility when it comes to salpingitis. The formation of acute salpingitis can be caused by incomplete or untimely treatment of tubal mucosal adhesions or pelvic inflammatory disease. It can also cause local infection of the endometrium and cause ascending infection, forming chronic salpingitis obstructing the fallopian tube channel, such as incomplete abortion, residual placenta-induced inflammation, some with intrauterine device, secondary to chronic salpingitis without acute salpingitis Performance, or only for subclinical infections, causes varying degrees of adhesion of the fallopian tube mucosa. Salpingitis can also be caused by inflammation of the organs or tissues surrounding the fallopian tubes, especially in the oviduct umbrella or around the ovary, so that the fallopian tube can not inhale the ejected egg cells into the egg tube, and meet sperm, such as suppurative appendicitis, Combined peritonitis and the like. The pathogens causing chronic salpingitis include bacteria, viruses, protozoa, and mycoplasma, among which bacterial infection is most common.
Bacterial infection (30%):
Common bacteria include Staphylococcus aureus, Streptococcus, Escherichia coli and Pseudomonas aeruginosa. These pathogens are found in unclean abortions, incomplete abortions, induced abortions, and puerperal infections. The spread of gonorrhea is mainly caused by sexual communicators.
Virus infection (25%):
There is still a diagnosis of trachoma medical source infection, whether mycoplasma and ureaplasma urealyticum cause infertility is inconclusive.
Other disease factors (15%):
Infant or adolescents with tuberculous peritonitis secondary to tuberculous salpingitis and even tuberculous endometritis and infertility, and tuberculous lesions are largely destroyed, mostly primary infertility, the success rate of assisted pregnancy technology is also lower than Other tubal inflammation. Endometriosis, pelvic endometriosis, ovarian endometriosis can form a peritoneal adhesion, so that the external adhesion of the umbrella end of the fallopian tube or adhesion around the ovary, so that mature eggs can not be ingested into the fallopian tube Infertility.
Prevention
Prevention of tubal obstruction infertility
The first thing to do is to keep the reproductive system clean and prevent infection of various pathogens.
In addition, most of the ectopic pregnancy is actually caused by partial blockage of the fallopian tube due to inflammation. In the case of ectopic pregnancy, to avoid the operation of laparotomy to remove the fallopian tube, laparoscopic fallopian tube fenestration should be used as much as possible. If circumstances permit, conservative treatment can also be used to preserve the fallopian tube.
In addition, if you find germline inflammation and pelvic and abdominal inflammation, you should actively seek specialists for effective treatment. It is not possible to perform tubal fluid and clear palace treatment in some small clinics.
Complication
Tubal obstructive infertility complications Complications, abortion, puerperal infection
The pathogens causing chronic salpingitis include bacteria, viruses, protozoa, and mycoplasma, among which bacterial infection is most common. Common bacteria include Staphylococcus aureus, Streptococcus, Escherichia coli and Pseudomonas aeruginosa. These pathogens are found in unclean abortions, incomplete abortions, induced abortions, and puerperal infections. Sexually transmitted diseases are mainly caused by gonorrhea infection. In addition, there are still trachoma medicinal infections, and whether mycoplasma and Ureaplasma urealyticum cause infertility is inconclusive.
Symptom
Fallopian tube obstructive infertility symptoms Common symptoms Lower abdominal pain Female infertility Menstrual cycle changes Menstrual scarcity Diffuse lower back pain Secondary infertility Late menstrual low low back pain
Clinical manifestations of lower abdominal pain, low back pain or abnormal menstruation, but many patients in addition to infertility, there is no conscious, uterine tubal iodine angiography can confirm the location and extent of tubal obstruction (complete or partial obstruction), see the fallopian tube Slender, beaded or stiff for tuberculosis, difficult to treat.
Examine
Tubal obstruction infertility examination
1, fallopian tube ventilation: that is, through the catheter into the uterus into the carbon dioxide, 60ml per minute, the pressure does not exceed 2.7kpa. If the fallopian tube is smooth, in the lower abdomen can hear the sound of gas passing through the fallopian tube into the abdominal cavity, and the pressure drops rapidly. If the fallopian tube does not work, you will not hear the sound of bubbles, and the pressure will not drop.
2, ultrasound imaging: ultrasound ultrasound injection of ultrasound contrast agent to observe the image of the uterus fallopian tube and uterine rectal fossa. Because physiological saline is a low echo medium, it can not directly observe the flow and display in the uterine fallopian tube under ultrasound. It can only infer whether the fallopian tube is unobstructed by observing the presence or absence of liquid in the rectal fossa, and its morphology and specific occlusion. unconfirmed.
3, laparoscopy: injection of pigment solution from the uterine mouth such as blue to the uterus, laparoscopic observation of the blue flow through the fallopian tube, spilling into the pelvic cavity, that is smooth; if there is obstruction, can not determine the obstruction. Laparoscopy can only understand whether the fallopian tube is unobstructed and the obstruction of the fallopian tube and the adhesion around the fallopian tube. There is no understanding of the specific blockage and nature of the fallopian tube.
Diagnosis
Diagnosis and diagnosis of tubal obstruction infertility
According to the history of infertility and various related examination results can be diagnosed.
1. If the fallopian tube fails during the fallopian tube ventilation, the sound of bubbles entering the abdominal cavity through the fallopian tube can not be heard in the lower abdomen, and the pressure does not drop.
2. Ultrasound sonography is indirectly inferred whether the fallopian tube is unobstructed by observing the presence or absence of fluid in the rectal fossa, and its morphology and specific blockage cannot be determined.
3, laparoscopic examination can understand whether the fallopian tube is patency and the obstruction of the fallopian tube and the adhesion around the fallopian tube.
