Virtually every woman wants to hearcherished "mother" from a son or daughter. However, for several reasons this is not possible. And one of those is poor patency of the fallopian tubes (which are popularly referred to as oviducts), which can lead to undesirable consequences such as tubal pregnancy or infertility. To determine the exact causes of this phenomenon, a woman is sent by a gynecologist for a special examination.
What it is, what it is for and how it can be resolved - read in this article. But first consider the likely causes of this kind of pathology.
As is known, under normal conditions, ripethe egg leaves the ovary and begins its journey through the fallopian tube, in which it helps cilia, carpets the entire inner surface of the epithelium. Here she hopes to meet with the male reproductive cell, resulting in fertilization.
The cells begin to divide, an embryo forms,which, with good patency of the fallopian tubes during a certain period of time, reaches the cavity of the uterus, where it is fixed on the wall of the endometrium. But under certain circumstances, the patency of the fallopian tubes can be changed, and then the course of pregnancy in normal mode is impossible.
Female genital organ, called the uterus,is the only cavity where full development of the fetus is possible. The possibility of successful conception and childbirth fully depends on the health of this organ and the condition of the fallopian tubes themselves.
According to experts in the field of researchinfertility, 30-40% of the total number of registered cases associated with obstruction of the fallopian tubes. The causes of this pathology, prompting to check the patency of the fallopian tubes, may be different. First of all it is:
Another cause of abnormalities in the structure of the uterinetubes, including their complete or partial absence, is an innate feature of the body. In addition, another reason to check the patency of the fallopian tubes can be strong various stressful situations or hormonal imbalances, only this happens very rarely.
To rule disappointing for mostwomen are diagnosed with infertility, or, conversely, to refute it, specialists need to understand why this phenomenon is caused. Then the appropriate treatment will be prescribed.
Как показывает медицинская практика, многие women learn about the presence of any inflammatory process at random during the diagnosis. In this regard, it is not necessary to abandon the planned gynecological examinations, which must be held every 6 months.
How do the diagnosis of patency uterinepipes and what is the procedure called? For this purpose, different methods are used, each of which has its own advantages and disadvantages. Proven years of painful methods and in addition require long-term clinical studies. In addition, they are carried out only using general anesthesia. As for modern techniques, they are relatively painless, general anesthesia in this case is not required.
Currently available such diagnostics:
To a woman choose the most appropriate typeresearch, she needs to consult a gynecologist in order to obtain gynecological history. And depending on this information, the doctor will advise the best diagnostic option.
There are a number of characteristic features, the presence of which allows a woman to think about the need to study the patency of the fallopian tubes. These include the following manifestations:
All these signs clearly indicate thatunwanted processes occur in the female body. Therefore, it is better to be safe once again, visiting a doctor. In addition, it is not possible to check the condition of the fallopian tubes on our own, since this simply cannot do without special equipment.
The patency of the fallopian tubes can be checked withoutgoogling high-dose x-ray exposure. The ultrasound machine enters the case, in which the reliability of the study is up to 90%. And nowadays several measurements are available: these are 2D, 3D and even 4D. This technique, in addition to the name hydrosonography, has another name - echosalpingography (echohydrotubation).
The method is simple to implement, the study is made directly in the office. To confirm or deny the diagnosis visually, the examination is carried out in two ways:
During the ultrasound examination of the fallopian tubesit all depends on the qualifications of the operator who controls the device, and its ability to correctly interpret the images taken. The procedure is performed during the period from the 5th to the 20th day of the menstrual cycle, but experts still recommend applying no later than the 8-11th day, since during this period the closest point of ovulation is the closest. In this case, the likelihood of spasms is minimal, it is easier to inject the concentrate.
В ходе выполнения диагностики у женщины могут be unpleasant sensations, which is a disadvantage of this type of research. In addition, you must comply with contraceptive measures before the procedure.
Many women are not interested in what is calledprocedure tubal patency, and how it is carried out. Specifically, this diagnosis refers to the surgical method, which is characterized by minimal damage to the skin. During the procedure, it is possible not only to establish the fact of obstruction, but also to eliminate the cause of the "blockage".
For this kind of operation are neededstationary conditions. On the surface of the skin of the abdominal wall are several small incisions. Subsequently, an optical system equipped with micro illuminators and a manipulator is inserted through them. In order to improve visual observation, the abdominal cavity is filled with carbon dioxide.
To assess the degree of patency of the fallopian tubes,An aqueous solution of methylene blue is introduced into the uterus, and a special video camera allows you to see if the substance passes through them. Moreover, the diagnosis is, as they say, in real time.
Поскольку такая диагностика требует оперативного intervention, albeit to a small extent, after its implementation requires a recovery period. Fortunately, in this case it passes quickly and usually takes from two to three days, not more.
Among all the available diagnostic methods, laparoscopy is the most accurate method, which is not inferior to either hysterosalpingography or ultrasound. In addition, the risk of formation of adhesions is the lowest.
Hysterosalpingography of the fallopian tubes is carried out by X-ray. In this case, you can:
The study is best done before ovulation in the follicular phase of the menstrual cycle. At the same time there is no need for anesthesia, and the procedure itself is carried out on an outpatient basis.
Everything is done as follows.A special contrasting substance is inserted through the cervical canal through the catheter into the cavity of the reproductive organ. Then X-rays are taken at the initial and final stage of the study. And they evaluate the results of GHA fallopian tubes.
Первое изображение позволяет произвести оценку shape of the uterus, determine the clarity of contours, as well as to identify possible pathological changes in the tubes, including the degree of patency. Thanks to the second picture you can see the distribution of the contrast material in the pelvic region, if, of course, it goes there.
If you compare this diagnosis with laparoscopy,then it is less accurate (only 80%). At the same time, it is well tolerated by women, despite the unpleasantness of the whole procedure. It is very important that there are no inflammatory processes. Let us dwell in more detail on this type of diagnostics and consider many features.
Если женщине была назначена hysterosalpingography (or GHA, in a simple way), it needs to be properly prepared for this procedure. For some reason, many doctors forget to warn patients that the procedure is quite painful and can cause a lot of discomfort. In this connection, we need a good moral preparation.
Перед проведением исследования у женщины на руках There should be fresh urine and blood tests. You may also need a gynecological smear and scrapings of the cervix and cervical canal. In addition, it is possible that tests will be needed for the presence of STDs (HIV, TORCH infections).
You should also fulfill a number of necessary requirements:
Another question that may arise inregards GHA fallopian tubes: on what day of the cycle is this procedure performed? As a rule, this is the period when menstruation ends, while ovulation has not yet come. It is at this time that the state of the endometrium makes it possible to detect the presence of endometriosis.
On the day of the procedure, the woman mustempty the intestines through an enema or laxative. And just before the start of the GHA it is worth visiting the bathroom. Do not interfere and take a sedative, which will allow uterine contractions not to interfere with the procedure itself.
When the hysterosalpingography is finished,within a few days (usually 1-3 days), the outflow of contrast material and blood is possible. Therefore, in the hospital is to grab with a tampons, pads or use disposable underwear.
The main medical indications for the procedureis the decision of the preliminary diagnosis - infertility. It is very important to carry out a number of additional examinations before the GHA of the fallopian tubes, blood tests or urine, since there are contraindications to the procedure, which include:
It is for this reason that before conducting the GHA procedure, analyzes and some other studies are needed.
Typically, a diagnostic procedure such ashysterosalpingography, it is safe for women, and after it there are no serious consequences or complications. However, it is impossible to completely eliminate any side effects. We are talking about an allergic reaction to a contrast drug, which is extremely rare. In addition, allergic manifestations may occur in the presence of bronchial asthma.
Complications after the GHA fallopian tubes may be early or late. Other complications include, in addition to allergies:
Complications of a late nature includeinflammatory reactions that occur due to infection during the procedure, again due to careless actions by the medical staff.
According to the pictures taken by the specialist can go totheir analysis. The result is evaluated by the degree of distribution of the contrast agent in the internal organs of the female body. If it is noticeable that it has penetrated the fallopian tube from the uterus, and from there already into the circulatory system, this indicates their good permeability.
In addition to the fact that in the course of this diagnosis you canjudge the degree of patency of the oviduct, you can detect a number of pathological changes that directly affect the health of the female body and serve as a serious obstacle to conceiving a child. These include:
Despite the fact that determining the degreepatency of the fallopian tubes by means of hysterosalpingography in medicine has been used for many years, the results are not always highly accurate. And this is even with the correct procedure. The accuracy of the results is evaluated by two criteria: sensitivity and specificity.
Currently to diagnose the conditionFallopian tubes for women can be referred to public or private clinics, where there is usually a wide range of services provided. A few decades ago, confirmation of infertility for a woman was a terrible diagnosis that simply put an end to the possibility of getting pregnant. But thanks to the achievements of modern medicine, it is no longer a problem to restore the functionality of the fallopian tubes.
Помимо вопроса, где делают ГСГ маточных труб, every woman is interested in the price of the procedure. It depends on the type of diagnosis, the degree of accuracy of the results obtained, as well as the possible risks of complications.
