If the fallopian tube is blocked, how to treat it?

1. Treatment of proximal tubal obstruction: The recanalization of proximal tubal obstruction can be performed by COOK's guide wire recanalization under hysteroscopy or partial tubal resection and re-anastomosis, and dredging the proximal guide wire can solve about 85% of proximal tubal obstruction, but the pregnancy rate after operation is quite different, ranging from12% to 39%, and the incidence of ectopic pregnancy is 2% to 9%.

2. Treatment of obstruction in the middle of fallopian tube: Lesions in the middle of fallopian tube refer to obstruction or missing changes in the middle of fallopian tube. Tubal anastomosis is a common surgical method for middle tubal obstruction, which is to remove the blocked part of fallopian tube under laparoscopy and anastomose the two broken ends of fallopian tube.

3. Treatment of distal tubal obstruction: Distal tubal lesions account for 85% of tubal infertility. The causes of distal tubal obstruction are pelvic inflammatory disease, peritonitis and previous pelvic and abdominal surgery.

(1) Tubostomy is one of the commonly used methods to solve the infertility caused by distal tubal obstruction. The pregnancy rate after operation is only about 30%, and the factors that determine the success of the operation are not only the surgical skills, but also the degree of tubal destruction.

(2) Tubal umbrella plasty: refers to the decomposition or expansion of the narrow fallopian tube that has not been completely closed to form hydrosalpinx. The surgical effect is quite remarkable.

(3) salpingectomy: Studies show that hydrosalpinx is harmful to in vitro fertilization-embryo transfer.

(4) Treatment of periadnexal adhesions: The decomposition of tubal ovarian adhesions can triple the cumulative pregnancy rate. If it is mild membrane adhesion, the pregnancy rate after operation is good, if the adhesion is dense, the outcome is poor. These patients had better be test-tube babies.