About 30% of women face a diagnosis of tubal infertility. This disease implies obstruction of the fallopian tubes, which is a natural obstacle to the penetration of the egg into the uterus. However, this state of affairs cannot be considered a sentence, and it’s not worth it to give up. As practice shows, in 80% of women with such a diagnosis attempts to cure lead to very positive results.
It is necessary to prepare in advance for the fact that the diagnosis and treatment of infertility will take a long period of time, so you should not expect a lightning effect. Lovely ladies, to conceive and quietly endure the baby, you will have to be patient. First of all, you will need to pass a lot of tests and be examined by a good specialist in order to determine the exact cause. A specific method of treatment is assigned only on the basis of examination results.
Tubal infertility: causes
Experts identify two main types of pathologies: functional and organic. The first type is considered to be the result of regular stress and depression. In addition, functional pathology arises due to an imbalance of prostaglandins, problems with the ovaries, hyperandrogenism. Organic problems are associated with the presence of inflammatory diseases of the genital organs, especially when the pathology was detected out of time, which contributed to the formation of adhesions of the fallopian tubes.
Tubal infertility: treatment
Based on the results of the tests and the identified causes, the gynecologist offers a drug treatment or surgery. Modern manufacturers of pharmacological products offer an extensive range of tools that promote healing, including biostimulants, and enzymes, and even antibiotics. In combination with taking medicines, other useful procedures will have to be performed, for example, ozokerite, mud and hydrogen sulfide baths.
Surgical intervention is the most radical measure, but in most cases it has a positive effect in the shortest possible time. Severe tubular infertility can be corrected by transplanting an impassable part of the tube, removing bends, or creating a new hole in the fallopian tube. If we talk about the safety of these procedures for the health of women, it is worth noting that the risk exists and must be taken into account. Laporoscopy is the safest operation, that is, thanks to small incisions, adhesions are dissected and certain areas are cauterized in order to destroy the likelihood of such adhesions recurring.
In some cases, all of the above methods do not allow a couple to conceive a child. Experts offer other ways by which the treatment of infertility is carried out - eco. In vitro fertilization involves the transfer of an already fertilized egg to the uterus. This procedure is practiced for a long time, and its effectiveness is beyond doubt. The main thing is not to lose hope, then everything will work out!
What is behind the diagnosis of "Infertility"?
Female sterility is the impossibility of a woman of childbearing age to produce offspring. There are two degrees of infertility:
- 1 degree - pregnancy did not occur even once
- 2 degree of infertility - pregnancy was in the anamnesis.
There are also absolute and relative infertility: the first is caused by irreversible anomalies of the female reproductive system, the second is amenable to adjustment during treatment. Tube infertility is considered relative.
Infertility of tubal genesis arises due to the appearance in the fallopian tubes of adhesions or fluids that do not allow a ripe egg to pass into the uterus and interfere with the meeting with the spermatozoon, and, accordingly, conception itself.
Distinguish between partial and complete obstruction of the pipe. If only one of the two fallopian tubes is impassable or the lumen is not completely blocked, then the onset of pregnancy is possible.
With the diagnosis of “incomplete obstruction”, the possibility of getting pregnant still exists, however, women with such diagnoses have gynecologists usually prescribed special drugs to stimulate ovulation.
What are the causes of the disease?
There are cases when obstruction of the fallopian tubes is caused by congenital pathologies of the development of the uterus, tubes and appendages. In addition, there are many reasons that can provoke tubal infertility in an initially healthy woman. In the first place among the causes are inflammatory diseases of the female reproductive system. Transferred in the history of genital infections, the presence of fibroids, surgery, abortion, the formation of adhesions in the pelvic organs. Endometriosis is another of the most common causes of tubal infertility.
There are cases when the disease is not associated with the above factors, but is caused by hormonal or metabolic disorders in the body.
In cases where the fallopian tubes are completely passable, but in some parts of them there are contractions with impaired functionality or the tubes are partially impassable, you should not leave it unattended, such violations can be no less dangerous and can cause ectopic pregnancy. Read more about ectopic pregnancy.
Often a woman may not even realize that she suffers from obstruction of the fallopian tubes, in principle there are no signs of illness, it can only be detected by means of diagnostics. It is worth worrying if you periodically worry nagging pain in the lower abdomen - this can be a symptom of obstruction of the tubes and, consequently, a symptom of tubal infertility.
How is obstruction diagnosed
Currently, there are several methods for the diagnosis of tubal infertility, which help determine how impassable the fallopian tubes. It should be noted that diagnostics should be carried out only in the complete absence of the inflammatory process and infections in the genital area.
The most accessible and accurate method is considered diagnostic CTG (kymographic hydrotubation). The fallopian tubes are flushed using a special apparatus that has an air reservoir, which allows us to determine the volume of air injected.
A kimograph allows you to note the change in pressure in the tubes and the uterus, based on the curve, the doctor makes a conclusion about the degree of patency of the tubes. This method of research allows not only to determine the condition of the fallopian tubes, but also, is a therapeutic method that provides a therapeutic effect, thus, it turns out that a woman receives a double benefit.
The next research method we will look at is hysterosalpingography. Diagnostics using this method allows you to find out which of the pipes is impassable and where the adhesions are concentrated.
During this procedure, a special substance is injected into the uterus and then pictures are taken. The first picture is taken immediately, the next after 10 minutes, and the final one after 24 hours from the moment the substance was injected. According to the results of the pictures, the doctor makes a conclusion about the condition of the fallopian tubes and uterus.
Note that hysterosalpingography may cause an exacerbation of the inflammatory process in the uterus and tubes, which in turn may lead to rupture of the fallopian tube. That is why, before making a decision on a research method, it is worth consulting with a gynecologist and learning about alternative diagnostic methods.
It is also worth considering that women with diagnosed infertility are not recommended to undergo X-rays more often than 2 times a year.
Female infertility of tubal origin can be diagnosed with biocontrast gynecography, allowing to identify adhesions that are located around the ovaries and fallopian tubes. The study is recommended in the second half of the cycle, however, it is strictly contraindicated for women with heart disease, hypertension, and tuberculosis.
This diagnosis cannot be carried out in case of inflammation of the genital organs or uterine bleeding. This method rather accurately allows you to determine the functions that are able to perform pipes, as well as indispensable for determining the width of adhesions.
Another method for detecting pathologies is laparascopy. In this study, we study the tissues that are involved in the inflammatory process. This diagnostic method is widely used in the preparation of women for surgery to restore the patency of the pipes.
So, as can be seen from the above, currently a sufficient number of methods are used in medicine to identify the obstruction of the fallopian tubes and diagnose tubal infertility. But it is worth remembering that the method of diagnosis is better to consult with your gynecologist, who will help you choose the most appropriate option in your case.
Is tubal factor infertility amenable to treatment?
Despite the fact that tubal infertility is considered one of the most complex forms, there are ways to combat this disease.
First of all, women who are treated with suspected infertility are examined for the presence of infections, which, if detected, are prescribed anti-inflammatory treatment. Of course, such therapy cannot cope with the problem of infertility, but it is necessary before intrauterine interventions: diagnosis and treatment of obstruction of the tubes.
Anti-inflammatory treatment helps to fight infection, but it is recommended to eliminate the effects of inflammation with the help of physiotherapy, which is able to restore nerve reactions in tissues, softens and even removes adhesions.
Blowing the fallopian tubes (hydrotubation) - another step in the treatment of tubal infertility. But it is worth remembering that this procedure, carried out repeatedly, can cause rupture of the fallopian tube, so it is carried out strictly according to the indications and under the supervision of the attending physician.
The most effective treatment for tubal infertility is considered operative laparoscopyThis method is used for dissecting adhesions that caused obstruction of the pipe. The method has much more advantages than abdominal surgery: after the intervention, the woman quickly recovers and returns to her normal life, the health risk is minimal, and there is practically no recurrence of adhesive disease.
Note that operative laparoscopy may be useless in some cases.
Quite often, there are situations when a woman cannot become pregnant after the treatment and restoration of the tubability. This happens when there are no peristalsis or microvilli in the tubes - such tubes are called dead.
What to do if after the treatment of tubal infertility, the desired pregnancy did not come?
Alternative methods of pregnancy
If after treatment two years or more have passed, and the pregnancy has not come, then it is worth contacting specialists and choosing another way to solve the problem. Tube infertility is an indication for IVF.
This procedure begins with tracking the menstrual cycle, then ovulation stimulation is performed. There is a careful monitoring of the maturation of the egg, in order to extract it in time.
The most important stage is the stage of fertilization of the egg and the development of embryos. If at this stage everything went well, the embryo is placed in the uterus, where the baby continues to grow and develop. A woman is prescribed certain medications that help maintain the body.
Summarizing all the above, I would like to emphasize that one of the most important factors in the treatment of tubal infertility is the psychological factor. Only a positive attitude and your confidence will help to cope with the problem. Follow the instructions of the doctor and be sure to believe in the success of the treatment!
Peritoneal infertility (tubal) is a factor in the absence of fertilization in a third of patients who lead frequent intimate life without using contraception and subsequent infection with sexually transmitted infections. There is the following classification of pathology:
- functional, impaired fallopian tube contraction ability,
- infertility of organic species in such a situation, the patency of the pipes will be disturbed from the outside (adhesions, growths), from the inside - during inflammation.
Peritoneal infertility in all cases is formed due to the formation of adhesions in the pelvic organs, which will be a response to inflammation. In addition, the pathological process is:
- primary, a woman cannot become pregnant initially,
- secondary, the patient had a pregnancy before, but after the possibility of natural fertilization disappeared.
Infertility can also be divided into:
- relative: there is a chance of natural fertilization,
- absolute: impossibility to become pregnant in the traditional way.
Obstruction of the fallopian tubes affects women regardless of age. Incorrect tube structure, the presence of a mechanical barrier in them or the uterus of the uterus makes fertilization impossible.
Symptoms of tubal infertility
Suppose peritoneal infertility is possible with the following symptoms:
- the patient had one or more surgical interventions in the lower abdominal cavity or on the organs of the reproductive system,
- the woman has had an abortion or there is a difficult recovery after childbirth,
- diagnostics of fallopian tubes patency,
- heavy discharge during menstruation,
- episodic pain in the lower abdomen,
- discomfort during the period of intimate communication.
Infertility itself has no specific features, except for the lack of the possibility of fertilization during regular intimate life without contraception.
The most dangerous consequence of the pathology is an ectopic pregnancy. The ovum after fertilization is implanted into the tube, ovarian tissue or other organs. Interruption is associated with heavy bleeding, pain, a sharp drop in blood pressure and other disorders that pose a threat to life.
Peritoneal infertility also gives complications as constant pain in the pelvis. The presence of the peritoneal factor of infertility is due to the formation of inflammatory diseases of the uterus, as well as surgical interventions that are carried out on it. Timely treatment helps to prevent dangerous consequences.
To detect the main symptoms of female infertility of tubal origin, a comprehensive examination is required. It usually assumes:
- analysis of patient complaints,
- study of the history of the disease,
- complete gynecological examination,
- smear collection for further microscopic diagnosis,
- PCR diagnosis of genital infections,
A radiograph is performed by injection of a contrast agent. Thanks to the device it is possible to assess the state of patency of the fallopian tubes. At the end of the procedure, the patient needs to protect herself for some time with intimate connections, since radiation has occurred.
When performing ultrasound inside the genital tract injected fluid. The device shows their throughput. Such a diagnosis is more harmless. Protection is not required.
Tube Infertility Treatment
Tube-peritoneal infertility is considered to be the most difficult. It is possible to treat TPB in the traditional way or with the help of surgical intervention. Treatment of tubal infertility involves.
- The implementation of complex therapy aimed at ridding the pathogen.
- The use of funds to increase the protection of the body. Constant inflammatory processes inside the uterus lead to immunological disorders, because recovery is required for proper disposal of the pathogen.
- Absorption treatment involves the use of enzymes. In some cases, apply hydrotubation with antimicrobial agents, hydrocortisone. Such methods are not very effective and provoke adverse effects: exacerbation of inflammatory processes, impaired mobility of pipes, etc. The use of Longidase candles is effective.
- Physiotherapy procedures involve a number of activities for the treatment of tubal-peritoneal infertility, which are designed to effectively deal with the obstruction of the fallopian tubes.
A surgical intervention in the treatment of TPB gives a better result than conservative ways of dealing with pathology. Выделяют такие основные виды радикальной терапии: лапароскопия, селективная сальпингография, микрохирургические вмешательства.
Симптомы развития трубного бесплодия у женщин
Женское бесплодие определяют как неспособность женщины к зачатию в детородном возрасте. One of the main forms of female infertility is this pathology, which, unlike the endocrine, is due to the pathology of the fallopian tubes or the adhesive process in the pelvic area.
Reliably diagnose these forms of the disease is quite difficult. First of all, the presence of all the following risk factors for the development of the disease: the presence of chronic diseases of the genital and other organs and systems (chronic tonsillitis, colitis, pyelonephritis, appendicitis). Important in the diagnosis are the course of post-abortion, postpartum, postoperative periods, the presence (or absence) of pelvic pain syndrome, pain during sexual intercourse, menstrual disorder (algodysmenorrhea), frequency of sexual relations and the number of sexual partners, inflammatory diseases of partners, the nature of pain.
In the diagnosis of the disease using special methods for the study of tubal infertility:
microbiopsy of fallopian tubes, etc.
Hysterosalpingography in the diagnosis of tubal infertility
Hysterosalpingography - One of the main diagnostic methods for suspected obstruction of the fallopian tubes. It can also give relative information about the adhesions in the pelvis. The essence of the method consists in bringing a special contrast agent into the uterine cavity and fallopian tubes, which fills all the existing cavities, after which a series of images is taken on an x-ray machine.
As a result, photographs are obtained in which the filling of the fluid of all hollow organs of the reproductive system is clearly visible, the narrowing and obstruction are immediately displayed on the photograph. After research, the substance is completely removed from the female genitals.
Laparoscopy in the diagnosis of female tube infertility
However, laparoscopy is considered the most informative diagnostic method. The absence of pregnancy after treatment for 6–12 months is often an indication for laparoscopic examination of the cause of infertility. However, this should not scare you. The operation itself is low-impact, but the effectiveness of this method is very high, perhaps it is after this method of examination and, perhaps, even treatment, you can finally become a mother. With this study, you can also remove the resulting adhesions, which often cures infertility.
Laparascopy is performed 1–3 months after performing hysteroscopy, with uncertainty of diagnosis and 6 months with normal hysteroscopy data. Currently, this method has become more informative and convenient due to the advent of a flexible endoscope, which is more convenient to work with. In addition, it is possible to eliminate some processes in the fallopian tubes during this study. For example, using catheterization of the fallopian tubes eliminates membfimbrial adhesions. In addition, signs of adhesions are characteristic of this form of infertility, which is manifested by a restriction of mobility and a change in the position of the uterus, shortening of the vaginal arches, and heaviness in the area of the uterine appendages.
During laparoscopy, the degree of adhesions is determined based on the degree of involvement of the appendages in the adhesions. When I and II of the extent of adhesions in the background of tubal infertility, there are membranous, easily ruptured adhesions around the fallopian tubes and ovaries. At III and IV degrees of adhesions in the small pelvis, adhesions are more often dense, they are equipped with vessels, difficult to separate, the uterus, intestines, and the omentum are involved in the pathological process of tubal infertility.
The main syndromes of infertility:
chronic inflammation syndrome (salpingo-ophoritis),
lack of ovarian function,
adhesive and asthenoneurotic syndromes.
Features of tubal infertility treatment in women
Comprehensive anti-inflammatory therapy should be of a phased nature and provide:
relief of the inflammatory process,
restoration of patency of the fallopian tubes,
correction of violations of their functions,
activation of the hypothalamic-pituitary system.
Treatment of tubal peritoneal infertility is carried out with drugs that stimulate ovarian function (estrogen, progestins), direct ovulation stimulants (Clomid, Serofen, etc.), vasoactive drugs. Apply also vasodilators that improve blood circulation and microcirculation (Trental, Theonikol, Nikokerin, etc.), antihypoxants (Aevit, vitamins A, E, C, Glutamic acid, etc.), biostimulants (PhiBS, aloe, Apilak, Biosed, etc. ), immunomodulators (Methyluracil, Pentoxyl, Dibazol, Immunal, Dekaris, etc.).
Surgical removal of tubal infertility
Microsurgical plastic surgery is widely used. The following possible surgical measures for the treatment of tubal infertility should be noted:
fibromiolysis - release of fimbriae from adhesions,
salpingolysis - separation of adhesions around pipes, elimination of kinks and curvatures,
salpingostomatoplasty - creating a new hole in the fallopian tube with excision of the narrowed obliterated part,
transplantation of the tube into the uterus, which is performed by occluding the tube in the intramural part and preserving its patency in the middle and distal parts.
Also, with this type of infertility, it is possible to use in vitro fertilization (by directly transferring the embryo to the uterus), which is sometimes the only way to get pregnant and give birth to a child after long-term treatment.
Contraindications for the surgical treatment of female tubal infertility
Contraindications for surgery are:
relative contraindications are considered to be the age of the patient over 35,
the duration of tubal infertility is more than 2–3 years and unpromising conservative treatment for more than 1.5–2 years,
frequent exacerbations of the inflammatory process in the uterine appendages and recently (up to a year) acute inflammatory process,
the presence of large hydrosalpinxes (inflammatory cysts), with the removal of which no more than 5 cm of pipe remains,
pronounced (III degree) adhesions in the pelvis.
The success of microsurgical plastic surgery in the treatment of tubal infertility depends largely on the correct postoperative management, which should include resorption therapy - electrophoresis with zinc and copper, magnetic therapy, ultrasound, enzyme preparations, direct electrostimulation of the fallopian tubes, etc. After surgery, contraception is recommended for 3– 4 months. The frequency of pregnancy after the introduction of microsurgical treatment in gynecological practice increased to 30-60%.
Physiotherapy for tubal infertility
Physical treatment methods are used to reduce the manifestations of inflammation (reparative-regenerative methods), eliminate adhesions (defibrosis methods), activate the endocrine system of the ovaries (hypothalamic-pituitary-inducing methods), stimulate reproductive function, improve the functional state of the central nervous and vegetative systems (sedative, tonic methods treatment of tubal infertility) and correction of disorders of immunogenesis (immunostimulating methods). These tasks help to implement the following methods of physiotherapy:
Reparative-regenerative methods: infrared laser therapy, paraffin, ozokerite-, pelotherapy, ascending shower, iodide-bromine, sodium chloride, hydrosulphuric baths.
Defibrosis methods: ultrasound therapy, drug electrophoresis of defibrosis drugs.
Hypothalamic-pituitary-inducing methods: transcerebral UHF-therapy, mesoencephalic modulation, endonasal galvanization.
Methods of stimulation of reproductive function: electrostimulation of the uterus and appendages, CMT on the uterus and appendages.
Immunostimulating methods for treating tubal infertility: LOC, heliotherapy, suf-therapy in suberybemic doses, thalassotherapy.
Sedative methods: electro-wound therapy, nitrogen, pine baths.
Toning methods: pearl baths, showers, therapeutic massage.
Hypothalamic-pituitary-inducing methods of physiotherapy of tubal-peritoneal infertility
Galvanization by endonasal technique. The constant current reflexively acts through the mucous membrane of the nose on the subcortical structures of the limbic system of the brain and activates the influence of the pathological hormones stimulating the functions of the ovaries, uterus and appendages. Procedures are performed with a current of 1 - 2 mA, for 10-15 minutes, daily, the course of treatment of tubal infertility is 10-12 procedures.
Methods of stimulation of reproductive function in tubal infertility
Electrostimulation of the uterus and appendages. Impulse currents cause irritation of nerve endings, afferent impulses - stimulations of the subcortical structures of the brain, including the hypothalamic-pituitary system, activation of the release of gonadotropic hormones that affect ovarian ovarian function. They use the cervical sacral technique, rectangular monopolar impulses with a frequency of 12.5 Hz, current strength up to the sensation of painless vibration, exposure time 5 minutes daily starting from the 5-7th day of the menstrual cycle, 2 cycles in a row, tubal infertility treatment 8 - 1 0 procedures.
CMT therapy on the uterus and appendages. Low-frequency currents cause irritation of nerve endings, afferent impulses - stimulation of subcortical structures of the brain, including the hypothalamic-pituitary system, activation of the release of gonadotropic hormones that affect ovarian ovarian function. Cervical sacral technique, I, II PP, modulation frequency 30 Hz, modulation depth gradually increases through the procedure by 50-75-100%, sending-pause 4-6 s, duration of the procedure 5-10 min, daily, 2 cycles in a row with 5-7th day of the menstrual cycle, tubal infertility treatment 8-10 procedures.
Sedative therapy for tubal female infertility
Coniferous baths. Contained in coniferous extract, essential oils and terpenes stimulate the olfactory receptors of the nasal cavity and the mucous membranes of the respiratory tract and reflexively cause an increase in the processes of inhibition in the cerebral cortex. Procedures are carried out at the rate of 50 g of needles extract per bath (200 l of water), at a water temperature of 36-37 ° C, for 10 minutes, daily or every other day, treatment of tubal infertility 10 baths.
Contraindications to physiotherapy for tubal infertility:
acute salpingoophoritis and endometritis,
uterine bleeding, severe vegetative dysfunction.
Sanatorium and method of treatment of infertility in women
Patients outside the exacerbation of chronic diseases of the female genital organs (salpingitis, salpingoophoritis, metritis, endometritis) are referred to climatic, balneo-and mud-curative resorts with hydrogen sulphide (Bakirovo, Hot Key, Yeisk, Krasnousolsk, Pyatigorsk, Talgi, Ust-Kachka), Radonovites, Radonovolsk, Eysk, Krasnousolsk, Pyatigorsk, Talgi, Ust-Kachka, Radonov, Gonachy Klyuch Belokuriha, Pyatigorsk), bromine (Yeysk, Ust-Kachka), sodium chloride (Anapa, Guy, Yeisk, Kaliningrad resort area, Kalinin, Krainka), nitrogen-siliceous water (Goryachinsk) at gipoesterogenii - on balneogryazelechebnye resorts with hydrogen sulfide, chloe idno-sodium, nitrogen-siliceous waters, while hyperestrogenia - with radon and bromine waters.
A significant improvement in their well-being, disappearance of pain in the lower abdomen and lumbosacral region, restoration of secretory and menstrual functions, normalization of libido, absence of tightness, compaction and soreness in the vaults during bimanual examination, normalization of blood flow and flow , complete (or almost complete) restoration of the contractile activity of the fallopian tubes and the onset of pregnancy.
Significant improvement is recorded if after 3 - 1 2 months the normal ovarian-menstrual cycle is sustained, the levels of estrogen, progesterone (pregnandiol), LH, FSH correspond to physiological parameters, there are no pathological changes in the internal genitals, indicators of kimography, rheography correspond to those of healthy women and within 2 years after tubal infertility treatment, uterine pregnancy occurs. The deterioration of the patient's condition is indicated by poor health, disturbed sleep, increased irritability and tearfulness, increased pain in the lower abdomen and lumbosacral region, impaired secretory and menstrual function, pastos and soreness in the vaults, impaired inflow and outflow of blood and worsening contractile activity of the fallopian tubes . Contraindications to the spa treatment of tubal infertility:
diencephalic syndrome with vegetative-vascular paroxysms.
Physioprophylaxis is aimed at preventing the development of diseases of the female genital organs by restoring the functions of the central nervous system (sedative and tonic methods), ovarian ovarian function (hypothalamus hypophysis-inducing methods), enhancing immunity and non-specific resistance of the body (immunostimulating methods).
Causes of tubal infertility
Most often the disease develops as a result of infectious inflammation of the fallopian tubes with a violation of their transport function. In addition, the disease may be due to anatomical and physiological changes (congenital anomalies, genital endometriosis), often occurs after an abortion or abnormal birth with damage to the mucous membrane of the fallopian tubes.
Salpingitis leads not only to obstruction of the fallopian tubes, but also to the disruption of their motor activity, dystrophic changes in the mucous membrane of the fallopian tubes, which prevent fertilization. During ovarian inflammation, ovulation may be impaired, and therefore the egg does not enter the abdominal cavity, and when adhesions form around the ovary (in the case of normal ovulation), it cannot penetrate the tube. In addition, oophoritis can impair the endocrine function of the ovaries.
The causes of infertility can be endocervicitis and colpitis, as purulent whites lead to the death of spermatozoa. In the etiology of infertility, endocrine disorders play a significant role. At the same time, ovarian function may be impaired initially, which is observed in case of abnormal development of the genital organs or damage to the ovarian follicular apparatus due to past infectious diseases or intoxications (egg maturation and ovulation are impaired, the hormonal function of the ovaries is reduced, which is necessary for maturation, transport of the egg and its ovulation fertilization).
Infantilism and hypoplasia of the genital organs also play a very important role among the causes of infertility in women. In addition, anatomical and functional features of the reproductive system contribute to infertility due to its underdevelopment (long narrow vagina with a shallow posterior fornix, narrow cervical canal, inferiority of cyclic processes in the endometrium, inadequate function of the oviducts, etc.).
Ovarian function may change a second time due to diseases of the pituitary, thyroid, adrenal glands. Diseases such as myxedema, hypothyroidism, severe forms of diabetes mellitus, Cushing's disease, obesity, etc., lead to tubal infertility. The cause of the disease can be injuries and displacement of the genital organs (old perineal rupture, gaping genital slit, prolapse of the vaginal walls, bends and uterine displacement, inversion of the cervix, urinary fistula, uterine cavity synechia, fusion of the cervical canal). Tubal infertility may be a concomitant symptom of endometriosis, tumors of the female genital organs.
General diseases and intoxications (tuberculosis, syphilis, alcoholism, etc.), as well as malnutrition, avitaminosis, mental diseases cause complex disorders leading to disruption of ovarian function, and therefore infertility may also occur. The cause of tubal infertility may be immunological factors (the formation of antibodies in the woman's body to spermatozoa).
Functional causes of tubal infertility
TO functional disorders is a violation of the contractile activity of the fallopian tubes:
discoordination (in different parts of the fallopian tube, the tone is increased, then lowered).
Numerous factors also lead to dysfunction of the fallopian tubes, in the presence of which you can develop tubal infertility:
strong psychological stress and emotional distress as causes of tubal infertility,
violation of the synthesis of sex hormones and especially their ratio in the body,
violation of the glucocorticoid function of the adrenal cortex and sympathetic-adrenal system, and other disorders.
Of course, the inflammatory processes in the fallopian tubes and in the small pelvis also affect the functional activity of the fallopian tubes.
Organic factors of infertility in women
Organic lesions fallopian tubes include obstruction, adhesions, torsion, sterilization, etc. Organic lesions of the fallopian tubes are usually accompanied by their obstruction to the egg in the uterine cavity.
Organic lesions of the fallopian tubes are currently not rare. They are provoked by:
воспалительные заболевания половых органов, пельвиоперитонит (воспаление только околоматочной жировой клетчатки) или перитонит (воспаление брюшины),
appendicitis with its subsequent operative removal, which also leads to adhesions in the abdominal cavity (however, for each woman the adhesive process is expressed differently, for someone more, for someone less),
operative interventions on internal genital organs (myomethomy - removal of myomatous nodes in the body of the uterus, resection of the ovaries, ligation of the fallopian tubes, etc.),
postpartum complications - inflammatory and traumatic,
polyps of the mucous membrane of the fallopian tube,
endometriosis tubal and other forms of external endometriosis.
If you have any of these diseases and conditions, you should think about this cause of infertility. It is worth noting, however, that all your fears need to be stated to the doctor, you will be helped to cope with the ailment only with your active desire to recover and become a mother.
Hormonal nature of tubal infertility
The mechanism of the effect of hormones on the physiological changes in the fallopian tubes is very complex. In normal operation, the fallopian tubes are aimed at ensuring the admission of spermatozoa and eggs, their nutrition and transport, and the embryo into the uterus for implantation into the endometrium. The occurrence of adverse conditions in the cavity of the tube leads to too fast or slow movement of the embryo, this may affect its further development and implantation.
In the fallopian tube there are 3 anatomical divisions that are under special neurohormonal control. The main mechanism in the admission of the egg and the movement of gametes are the movement of cilia (fimbriae) on the surface of the cells lining the tubes, as well as the movement of muscles and the flow of fluid in their cavity. The speed of the flow of fluid in the cavity of the fallopian tubes largely depends on the ratio of sex hormones during the menstrual cycle.
During the ovulatory and pre-ovulatory phases of the menstrual cycle, when the smooth muscles of the fallopian tubes are dominated by estrogens, a block is formed in the isthmus of the tube that prevents the immature fertilized egg from entering the unprepared endometrium of the uterus. Before ovulation, there is a peak in estrogen secretion, which leads to a maximum increase in the tone of the fallopian tube (it almost does not relax), which delivers the fertilized egg to the uterine cavity.
Further in the follicular phase of the cycle, the tone of the tubal-uterine part is reduced, and the isthmic-ampular part of the tube is increased. As a result, this allows the ovule to be in the isthmic-ampular part for 24 hours, where the early stages of division occur. The fertilized egg is inside the fallopian tube for 2–3 days. Hormonal causes of female infertility lead to violations of the process of division and evacuation of the egg.