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Hydrotubation increases pregnancy rates

As a matter of fact, infertility remains a major reason for gynecological consultation in both developed and developing countries. It is often associated with social consequences like marital instability, divorce, and even suicide in extreme cases. There is no doubt that tubal factors remain a common cause of female infertility all over the world.

 

Methods of managing tubal factors in infertility include gaseous insufflation, hydrotubation, microsurgery, hysteroscopic catheterization and in vitro fertilization. Hysterosalphingography (HSG) is a first-line diagnostic tool for assessing the status of a tube. It is a relatively easy procedure which provides a measure of tubal diameter, locates tubal occlusion and identifies pathologies such as hydrosalpings, and salpingitis isthmica nodosa. We hypothesize that hydrotubation, which is a simple effective noninvasive procedure for tubal factor, increases pregnancy rates.

 

According to a study done by “Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Shika-Zaria Kaduna State, Nigeria”, among all the methods stated above, hydrotubation turns out to be a top solution to improve fertility of women with distal tubal occlusion after reproductive surgery.

 

Two hundred and fifty seven patients that had therapeutic hydrotubation over 7.5 years were analyzed. The age range was 21 to 44 years with mean of 34.5 years. Secondary infertility was found in 209 (81.3%) patients and primary infertility in 166 (64.6%) patients. Of the 257 patients, 134 (52.1%) had had induced abortion. Indications for hydrotubation were bilateral perifimbrial adhesion (incomplete tubal occlusion) 47.9%, bilateral fimbrial end occlusion 24.9%, bilateral cornual blockage 16% and unexplained infertility in 11.3% of cases. One hundred and nine conceptions were recorded in this study and the overall conception rate was 42.4%.

 

Likewise, percentage ratio of conception in these 154 patients with evidence of post – hydrotubation tubal patency was 70.8%. Pregnancy outcome of the 109 conceptions are term pregnancy 84.4%, preterm pregnancy 9.2%, miscarriage 4.6% and ectopic pregnancy in 1.8% of the conceptions. Recorded complications were pelvic pain in 177 (68.9%) patients and vaginal bleeding in 63 (24.5%) patients.

 

The conclusion for the above experiment is that with good case selection, therapeutic hydrotubation may be beneficial in resource poor countries, especially in patients with incomplete tubal occlusion (bilateral perifimbrial adhesions) and as part of treatment for unexplained infertility. On the other hand, the use of hydrotubation can be highly recommended because of the technically easy administration and the wide therapeutical scale (cleaning of the tube, fimbriolysis, antiphlogistic effect on the tubal mucosa, stimulation of ciliar activity, desobliteration, neuroreflective induction of ovulation) especially as an additional treatment in the field of diagnosis and therapy of the pathological tubal factor.

 

As stated above, hydrotubation is now considered to be a simple effective noninvasive procedure for tubal factor to increase the pregnancy rates of infertile women. However hydrotubation is not the top solution for every infertile female. It was reported by the women that 8 of them after hydrotubation experienced hypogastric pain persisting for some days, and in 6 there was acute adnexitis. Destructive changes in uterine adnexa, being estimated during the reconstructive operation, were decidedly more advanced in women treated by hydrotubation.

 

For these women treatment with Chinese herbal medicine (e.g. Fuyan pill) instead of surgery is more recommended. 

 

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