Fallopian tube - two thin channels, one on each side of the uterus, which descends mature egg from the ovary into the uterus. Obstruction of the fallopian tubes - a disorder in which the egg can not pass through the fallopian tubes. Blocked may be one or both fallopian tubes. This disorder is also known as tubal factor infertility; obstruction of the fallopian tubes is the cause of infertility in 40% of cases.

As obstruction of the fallopian tubes causing infertility

Each month during ovulation Ovulation - How to determine as accurately as possible? One ovum is released from one of the ovaries. The fallopian tube into the uterus of the egg down. In order to fertilize an egg, sperm must pass through the cervix, uterus and into the fallopian tubes. Normally, fertilization occurs at a time when the egg moves through the fallopian tube.

If one or both fallopian tubes are blocked, the egg can not get into the uterus, and sperm can not reach the ovum, resulting in fertilization and pregnancy become impossible.

If the fallopian tube is blocked only partially, the risk of the pipe, that is an ectopic pregnancy.

What hydrosalpinx

A special type of tubal occlusion, hydrosalpinx - a disorder in which the fallopian tube is expanded and filled with fluid. Liquid also blocks the movement of the egg and sperm, preventing fertilization and pregnancy.

Can I become pregnant while obstruction of the fallopian tubes

If disabled, only one of the fallopian tubes, the possibility of pregnancy is maintained. It depends on how well the tackle while functioning ovaries and what is the cause tubal occlusion.

Symptoms

Obstruction of the fallopian tubes rarely causes any symptoms. When hydrosalpinx may experience pain in the lower abdomen, as well as unusual vaginal discharge, but it is not every woman with such a diagnosis.

Sometimes blockage of the fallopian tubes can be very painful periods and pain during sexual intercourse, but it is - non-specific symptoms of this disorder.

Causes

The most common cause of obstruction of the fallopian tubes are pelvic inflammatory disease. Often, but not always, pelvic inflammatory disease are the result of sexually transmitted diseases (STDs). In addition, even if a violation of long-cured, pelvic inflammatory disease history increase the risk of obstruction of the fallopian tubes.

Other possible causes obstruction of the fallopian tubes:

• Active STDs or sexually transmitted diseases in history, especially chlamydia and gonorrhea Gonorrhea - self-ruled ;
• Infection of the uterus caused by abortion or miscarriage in history;
• Perforated appendicitis in history;
• Abdominal surgery in history;
• Ectopic pregnancy in history;
• Previously undergone surgical operation that affected the fallopian tubes;
• Endometriosis.

Diagnostics

Obstruction of the fallopian tubes is usually diagnosed by a special X-ray - hysterosalpingography Hysterosalpingography - effective examination of the uterus   (GHA). During the procedure, the cervix is ​​administered through a special colorant, followed by direct study of X-rays.

If all goes well, the dye passes through the uterus, fallopian tubes and ovaries through will result in pelvic cavity. If the dye does not pass through the fallopian tube, it can be assumed that the fallopian tubes of women.

It is important to know that 15% of women test gives a "false positive" result when the colorant does not fall out of the uterus into the fallopian tubes. In this case, it seems that it is blocked by the place where the fallopian tubes are connected to the uterus. Having such a result, the physician conducting the test again and / or uses other methods of diagnosis.

Among other methods, which are used length diagnostic tubal occlusion - ultrasound, laparoscopy or hysteroscopy diagnostic Hysteroscopy - examination of the uterus inside . The blood of the patient is tested for chlamydia and other STDs.

Treatment

If only one blocked fallopian tube, it usually does not cause much inconvenience. Women with this disorder who wish to conceive, sometimes prescribe medications that increase the likelihood that oocyte maturation is on the side where the fallopian tube is open.

When obstruction of both fallopian tubes can be opened using laparoscopic surgery; during surgery removed scar tissue, which blocks the pipe. Unfortunately it does not always help. The chance of a successful completion of the operation depends on how old the patient (younger than she is, the better), how much is blocked fallopian tubes, and that is the cause of obstruction.

The high frequency of male infertility requires an examination of the patient by a specially designed custom protocol. This allows you to identify the direct cause of the disease and treat male infertility, taking into account the correct diagnosis. During the course of therapy should be to completely eliminate the influence of factors that adversely affect the male reproductive system. Drinking alcohol, smoking, taking certain drugs, thermal effects should be minimized.

Drug therapy of infertility

The use of drugs for correction of conservative male infertility is permissible if there is an infection of the reproductive organs, endocrine disorders, and sexual and ejaculatory disorders. One of the leading causes of infertility factors is an infection that can infect the genitals of men and lead to the development of the disease in 22% of cases. In establishing the existence of urogenital infections is assigned a complex antibacterial, anti-inflammatory, metabolic therapy. The antibacterial drug should be chosen based on the particular pathogen, since it provides positive results of therapy, for example, the use of macrolide for the treatment of urogenital chlamydiosis.

Accumulated experience in the treatment of male infertility to determine the primary group of drugs which are used to normalize various disorders of spermatogenesis. This applies to endocrine disorders, which are the direct cause of the male infertility. With the purpose of treatment prescribed following hormones Hormonal treatments - not only contraceptives :

• HCG, or human chorionic gonadotropin. It is used as a monotherapy (i.e., only one active drug) or in combination with menotropinami. Preparation of hCG at a dose of 1500 IU administered three times a week, and if it is combined with menotropinami, its dose should be reduced to 500 IU
• male sex hormones, or androgens. The main representative of is testosterone preparations Five myths about testosterone . It is administered in a daily dose of 120 mg. It is necessary to take into account the presence of a high percentage of side reactions and complications of such therapy on the background, so the patient must be under medical supervision
• drugs that selectively inhibit the secretion of the hormone prolactin Prolactin - effect on the body is not fully known . In monotherapy administered bromocriptine or cabergoline. Cabergoline has a more convenient mode of reception - twice a week 0, 5 mg

The complex of conservative treatment should include drugs of different pharmacological direction - anti-estrogens, cardiovascular drugs and enzymes. It provides exposure to different levels of development of the pathological process. Upon reaching normal sperm fertility and restore reproductive function in men can talk about a certain positive result. If within six months of pregnancy does not occur, it should further examine the couple, because at the time of the first survey, may not have been installed all the causal factors of infertility.

Indications for surgical correction

In a study of men can be identified pathologies that require surgery alone. Such conditions are congenital anomalies or malformations, and anomalies in the area of ​​the stricture of the urethra, hernias (inguinal, and inguinal-scrotal), varicocele Varicocele - when it hurts the scrotum , Cryptorchidism. Varicocele in the structure of the causal factors of infertility from the man in second place and is diagnosed in nearly 15%. In this disease the surgery is performed in patients aged 25 to 30 years, thus it is necessary to inform the couple that guarantees the success of the surgery conducted in the form of pregnancy one can not give.

Great importance is attached to conduct microsurgical operations with the aim of restoring patency of the vas full paths in the event of obstruction and normal parameters of spermatogenesis. To judge the safety of spermatogenesis can be based on the result testicular biopsy in conjunction with the assessment of patency of the vas ways using X-ray examination or angiography.

In most cases, the diagnosis of male infertility is based on objective criteria of diagnosis. In the case of border regulatory male fertility is very important is not the fact of the differential diagnosis and the choice of an integrated treatment that will successfully realize the function of procreation.

Marina Solovyov