Last time we talked about the examination of fallopian tubes (click to view), the common result of hysterosalpingography is [not smooth], so patients often ask this question:
I did hysterosalpingography and found [fallopian tubes pass but are not smooth], how should I treat to be pregnant?
In fact, for doctors, this is a big problem, which is really not clear in a word or two. We will give the corresponding treatment plan according to the situation of each infertile patient (factors such as what disease, lesion location, age, infertility time, etc.).
But in general:
- Some people need to treat fallopian tubes before trying pregnancy or other treatments. Some people have little significance in treating fallopian tubes, so it is better to do IVF directly. Others, the specific condition needs specific analysis.
Today, I’d like to show you the examples of two patients, which are also infertility caused by obstruction of fallopian tubes, but the treatment is different.
Laparoscopic surgical treatment
Example 1:
28 years old, married for 2 years, without contraception for nearly 1.5 years, without pregnancy. Menstrual cycle is irregular, between 30 and 60 days. Examined the husband’s semen, is normal.
She was treated in the local hospital, monitored ovulation and induced ovulation, and instructed the couple to share the same room for several months without pregnancy. Later, hysterosalpingography was performed and bilateral fallopian tubes were found to be unsmooth.
The doctor advised her to do IVF, but she was confused and wanted to hear my opinion. My advice to her is that she can consider IVF or laparoscopic treatment.
- First of all, tubal obstruction does not mean [absolutely cannot be pregnant]. Second, irregular menstrual cycle means that there may be ovulation disorder, which affects pregnancy. However, ovulation monitoring/ovulation induction has been carried out in the local area for several months and is still not pregnant, which indirectly indicates that tubal may be the main cause of infertility.
Since this patient is still relatively young (less than 35 years old), combined with the previous situation, it can be treated for fallopian tubes.
To put it simply:
- Younger; Not having undergone pelvic surgery; Infertility time is not long; Tubal factors lead to infertility.
Generally, for such patients, it is recommended that patients undergo laparoscopic surgery. If you are not pregnant one year after laparoscopic surgery, you can do IVF again.
IVF therapy
Example 2:
39 years old, regular menstrual cycle, marriage for 1 year, cohabitation for 5 years, has not used formal contraceptive methods, adopted is [safe period contraceptive method], nearly 2 months without contraception. Four years ago did an induced abortion, two years ago removed hysteromyoma.
After examining her husband’s semen, it is normal. Just did hysterosalpingography examination and found that both fallopian tubes were not smooth.
For this patient, my suggestion is to do IVF, because:
- Only 2 months without contraception, should not be considered infertile. () However, safe period contraception itself [unsafe], has 5 years of cohabitation history, has not been pregnant once, [hasty contraception] so successful, may not be a good thing. In addition, she is 39 years old, and has had two operations; Hysterosalpingography showed that bilateral fallopian tubes were unobstructed.
To put it simply:
- Older (over 35 years old); Infertility lasts for a long time (this should be judged by doctors); Having undergone pelvic surgery; Tubal factors lead to infertility.
Generally, for such patients, it is not recommended to perform another operation (), so the advice to this patient is to do IVF.
Here are two simple examples, which do not include all the situations. I just want to tell you that each patient’s situation is different, and the treatment plan is also somewhat different. Doctors cannot give treatment suggestions just based on a laboratory test form, a B-ultrasound result or a other examination report.
If you find abnormalities after an examination, don’t be too anxious and don’t rush to find a one-step solution. Cooperate with a good doctor and ask the doctor to know his situation in detail and comprehensively so as to find the most suitable treatment plan and conceive the child.