Consequences of removal of the fallopian tubes. Natural pregnancy without fallopian tubes

As long as I have at least some chance to give birth - I will go to the end! In the end, there was only one pipe left, if something happens, then there will be nothing to remove for the last time and more

Twentieth story within the contest "My story of infertility"

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My story is reversed

We met my future husband 2 years before the formalization of our relationship. We have been preparing for the wedding for a year, and this day has become one of the most happy days in our life.

And six months before the wedding, we began to prepare for pregnancy, because. both of them really wanted to send our great love to someone else as soon as possible.

Approached the matter with all seriousness, passed necessary examinations, visited necessary doctors and received "good"!

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They celebrated the wedding, flew off on their honeymoon trip and ... The three of us are back from there!

Happiness knew no bounds

I just enjoyed my pregnancy, even morning morning sickness made me happy - it was indisputable proof that a miracle lives in me!

I easily departed 9 months and gave birth to an excellent healthy son. True, not by herself, as she was set up until the last moment, but with the help of the COP, but spinal anesthesia somehow compensated for the fact that I could not give birth on my own, because I heard everything and saw my baby right away, even in the operating room.

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Everything was great, the stitches healed quickly, we were allowed to go home at the appointed time and we began to enjoy this incredible status - parents.

Time to repeat

A year has passed and we began to think about the fact that it would be nice to repeat what worked so well. I myself went to the doctor, passed necessary minimum analyzes and received "good".

Time passed, pregnancy did not occur. This alarmed us a little, but I attributed everything to the fact that we were still actively breastfeeding and something was missing on the hormonal background.

Breastfeeding ended when the child was 1 year and 7 months old. More time has passed, pregnancy does not occur.

I changed the gynecologist, again passed everything, absolutely everything, necessary tests. I sent my husband to the doctor, he also heroically passed all the necessary tests.

There were some non-critical deviations. All doctor's recommendations were followed. The analyzes have been resubmitted. Have improved. We tried our best.

I'm starting new cycle and somehow unexpectedly, just on the 9th day of the cycle, the chest starts to hurt, well, just like usual after ovulation.

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It worried me, I thought - hormonal disbalance. But after I put the baby to bed, I decided to take a pregnancy test anyway ...

The test drew a beautiful second stripe

I go straight to my husband he was happy, but for some reason I was not…

And there was only one thought in my head:

It can’t be, it’s not normal, because my menstruation has just ended, if only it wasn’t ectopic!

We decided not to tell anyone until we were convinced that the pregnancy was the most normal. I myself tried to believe it so much that, in spite of everything, I lay down on planned operation with son.

In parallel with the preparation for hospitalization with a child, I regularly took tests for hCG, he grew slowly, not as expected, which only confirmed my doubts.

I went for an ultrasound scan twice a week, we stubbornly searched for a fetal egg, the gynecologist also immediately suggested a tubal pregnancy, but time passed, nothing hurt me, there was nothing in the uterus, hCG, though slowly, but grew. Hope melted before our eyes. But I hoped and believed in a miracle.

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Miracle didn't happen

From the children's hospital, I "moved" to the gynecology, where they removed my right tube.

To say it was a shock is an understatement. The shock was for everyone, because no one knew.

My mother had to be asked to go to the hospital with the child, and I probably stole several years of her life from her, because she was very worried.

And I myself really wanted to sob and cry, and everyone calmed me down. I remember right after the operation I told my husband that I didn’t want any more pregnancy, that we have a son and it's wonderful, many people don't have such happiness.

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A few more days passed. I calmed down, the consequences of the operation somehow began to pass, the doctor said that the second tube was just perfect, and after the CS everything is very good, and I said:

As long as I have at least some chance to give birth - I will go to the end! In the end, there was only one pipe left, if something happens, then there will be nothing to remove for the last time and more

And how I looked into the water

As soon as we were allowed to get pregnant, we slowly got down to business. One morning I woke up with pain in my left side, which was madly left leg so I couldn't walk.

I was lying. Then I became scared, and I decided to go to the hospital to surrender. At the emergency hospital, they didn't tell me anything, except that “oh, you have a CS and laparoscopy, it could be adhesions.”

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After two hours of sitting in the hospital, the sight of her seemed to make me feel better, if only I didn’t lie in it, and we drove off. But not home, but to the children's hospital - the child complained of pain in the ear, and after we started going to the garden, he often had otitis media.

And it just so happened that on the way to the children's hospital we maternity hospital, and with it a perinatal center, where, in general, I decided to go just in case.

From there I was not released

The second tubal pregnancy was a complete surprise. It's only been six months since the first one. Nothing could happen so quickly! After all, we could not get pregnant so much before.

How the doctor in the emergency room scolded me, by the way, the same one who removed my first tube and said that everything was fine with the rest.

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How I cried, how I could not sleep all night before the operation, how I regretted that we were in a hurry, how I scolded myself for my irresponsibility, how sorry I was that I would not be able to give birth to my child a brother or sister, as I was scary.

I had my left tube removed this morning. and for some reason they sent me to intensive care until the next morning (the first time I was transferred to the ward almost immediately). I really asked the nurse to call my mother, who was going crazy.

I felt better than after the first operation and by the evening I could walk on my own. And at night I had a lot of time to feel sorry for myself and cry.

For the first year, it was very hard for me to hear the good news about someone's pregnancy, to see expectant mothers, to find out that someone had given birth. It was really hard for me, every time with such news something inside was shrinking.

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I just ran to the child, hugged him and thanked God that we have a son, healthy, dear and so beloved.

And I still say every day: “Lord, thank you for my son!” and I ask why he sent me these tests, but so far I can’t understand why.

Now I am again sincerely happy with all the pregnant women I know, newly-baked mothers, I love to squeeze babies, I just smile when I see pregnant girls on the street, thinking about what kind of happiness awaits them ahead.

Apparently, in order to let go of this pain, you need to fully accept and realize it.

Life is not over, and my infertility story is just beginning, because there are many more ways to become a mother again ...

The uterine or fallopian tubes are one of the elements of the female reproductive system that transports a fertilized egg to the uterus. Pregnancy without tubes naturally is impossible, but it is quite acceptable if at least one of them is present, or if an artificial insemination procedure is carried out.

Functions and obstruction

They are a paired organ located in female body on both sides, symmetrically to each other, and connect the ovaries to the uterus. The egg matures in the follicle, and after reaching its maturity and rupture of the membrane, it penetrates into, where it is fertilized by the sperm. Then, the cell divides and grows within a week, after which, already at the stage of the embryo, it enters the uterine cavity.

The most common pathology is obstruction. With such a disease, normal pregnancy diagnosed in only 5% of women. In most cases, an ectopic pregnancy occurs, requiring its artificial termination, by surgical intervention. Otherwise, rupture may occur and internal bleeding may occur.

Initial treatment for obstruction medicines, and in the absence of a positive result, surgical intervention is necessary. Having decided on the operation, it is important to understand that the natural removal of the tubes is impossible. Then the only way to have a baby is the IVF procedure, in the absence of fallopian tubes.

Sometimes, due to medical indications, or at the request of a woman, for example, during surgery caesarean section, they are bandaged. In this case, due to poorly performed manipulations, with a minimal, almost zero probability, a natural pregnancy may occur. But, if you want to have a baby, you can carry out the IVF procedure with your tubes tied.

Artificial insemination in the absence

For entry into the protocol, their is not a contraindication. After the removal operation, the woman is left without tubes.

without fallopian tubes? With in vitro fertilization, the presence or absence does not matter, since they are not involved in the procedure. To a certain extent, their absence contributes to a more successful implantation of the embryo. This is due to the content of fluid that prevents the embryo from staying in the uterine cavity, which is why pregnancy does not occur.

IVF after removal of the pipes is carried out according to the same scheme as if they were present. The patient passes full examination, testing, and based on the data obtained, treatment is prescribed.

If the cause of infertility is a tubal factor, IVF may be successful the first time or the second time, since the fertilized egg is transplanted immediately into the uterine cavity, bypassing the previous steps. The positive chances of IVF with one tube are the same as with two, or none at all.

Removal before protocol

It has been observed that in patients diagnosed with obstruction, the success rate of embryo transfer varies. Studies have shown that hydrosalpinx disease plays a significant role in the result of the procedure, which, when the embryo is transplanted, almost halves the chances of pregnancy.

Do tubes need to be removed before IVF? If the patient had several attempts at an unsuccessful protocol, then the removal of the tubes before IVF will solve the problem with the survival of the embryo, in positive side. Mothers who have managed to get pregnant after repeated unsuccessful attempts, in most cases, note that this happened after the removal operation.

According to statistics, mothers who removed tubes before IVF were able to give birth to a child in 60% of cases, against 25% of women who did not agree to the operation.

When can I do IVF after removal? Recovery period after surgical intervention usually is 2-6 months. For each patient, the time of entry into the protocol after surgery, the attending physician specifies individually.

Is it possible to do IVF without removing the tubes? The decision to remove is taken only by the woman. But, it should be remembered that the chance for a successful embryo transfer after the operation is much higher than before it, since the focus of infection is removed, which interferes with normal development pregnancy. This is especially true if hydrosalpinx is diagnosed, which increases the risk of a negative result.

Today, almost every woman has a chance to give birth to her own child. Since cases of pregnancy in a natural way, in the absence of tubes, are impossible, attention should be paid to the procedure of artificial insemination. This is the only opportunity to experience the feeling of motherhood in a situation like this.

Fallopian tubes, they are also oviducts, fallopian tubes are two thin long processes coming from the uterus on both sides and reaching the left and right ovaries. Together with the ovaries, the tubes make up the uterine appendages, with inflammation of which the diseases are called salpingitis (tubes), oophoritis (ovaries), (salpingoophoritis, adnexitis), hydrosalpinx.

The role of the fallopian tubes in conception

In one of the ovaries every month healthy woman the dominant follicle matures, during ovulation, approximately in the middle of the cycle, when the follicle ruptures, the egg is released, giving rise future pregnancy. From the ovary, the egg must enter the fallopian tubes and move along them towards the uterus. At this time, spermatozoa from the vagina rush through the cervix, the uterus itself to the fallopian tubes towards the egg, where they must fertilize it.

After that, the egg already becomes an embryo and continues its journey through the tubes to the uterus, this period is usually 7-10 days. With failed fertilization, the egg dies and is absorbed within a day. Therefore, the fallopian tubes play the most important role of transporters that deliver the egg to the uterus.

The length of the fallopian tubes is almost 10 cm, and the diameter is only 1 cm, and the internal canal of each tube is only 0.1 cm to 1 cm (narrow at the entrance to the uterus, wider at the ends of the tube). However, this is quite enough for microscopic eggs and sperm to move freely in them.

What is the danger of obstruction of the fallopian tubes?

In cases where both or one tube is blocked, inactive, rigid, or the mobility and function of the cilia (villi, fimbriae) that direct the egg into the fallopian tube are impaired, pregnancy cannot occur. Obstruction of the tubes for a woman's health does not pose a threat to life, but is one of the most serious problems with conception and the cause of tubal infertility.

Today, clinical data state that 15% of married couples are faced with the problem of infertility due to the woman's fault, and 20-25% of this number belong to problems with the patency of the fallopian tubes. Moreover, with various deviations, dysfunctions of the uterine appendages, with a partial blockage of the tubes or an inflammatory process in the appendages, it is very formidable, which can deprive a woman of one of fallopian tubes.

The main causes of obstruction of the fallopian tubes

It should immediately be noted that the concept of obstruction includes several pathological conditions:

Complete obstruction of the tubes
One impassable pipe
Adhesions around the uterine appendages
Partial obstruction - since the movement of the egg occurs due to the contraction of the tube, with various pathological conditions its contraction is disturbed and the transportation of a fertilized egg is difficult, sometimes leading to ectopic pregnancy
Violation of the activity of the villi, fimbriae, which are not able to capture the egg and send it to the fallopian tubes

Obstruction can occur both when a narrow channel inside the pipe is blocked, and during the adhesive process due to squeezing the pipe from the outside. The main causes of obstruction of the fallopian tubes are as follows:

Inflammatory diseases of the uterus

Any inflammation of the uterine appendages can occur both acutely and latently, with few symptoms, especially with such latent sexual infections as ureaplasmosis, mycoplasmosis, cytomegalovirus infection etc. In acute processes, treatment is carried out in a hospital with antimicrobial, anti-inflammatory drugs, then a long course of recovery, resolving therapy is carried out. But with latent infections, the process is not noticeable. During the reproduction of bacteria, their waste products, mucus, pus fill the narrow passages in the fallopian tubes. If not produced timely treatment and absorbable therapy, adhesions and scars remain on thin sensitive walls, which leads to partial or complete obstruction.

Tuberculosis of the female genital organs

In many sources medical literature it is indicated that tuberculosis very rarely affects the genital organs and is considered not common cause infertility. However, today the decline in the health of the nation, the fall in immunity among the population, as well as the resistance of Mycobacterium tuberculosis to drugs leads to the fact that many chronic patients who cannot be treated, as well as unexamined citizens, live in cities. Infection and morbidity in children is becoming very high. And almost the entire population becomes infected with Koch's wand before the age of 15-20, and the disease can manifest itself years, decades after infection.

It should be borne in mind that the insidiousness of this disease is that it affects not only the lungs, but also any organs. human body and proceeds asymptomatically, besides, extrapulmonary forms are extremely difficult to diagnose. When a girl is infected during the growth and formation of the genital organs, tuberculosis can lead to abnormalities in the development of the uterus and appendages, to hormonal imbalance, underdevelopment of the mammary glands (hypomastia), to complete obstruction of the fallopian tubes, and to impaired ovarian function.

The insidiousness of this infection is also in the fact that after infection, the immune system copes with mycobacteria and the foci of inflammation subside on their own. And with a decrease in immunity, with a sharp exhaustion, abuse of diets, severe stress, during puberty or hormonal changes, very often after childbirth - a relapse may occur again. Moreover, the x-ray of the lungs in this case in a girl or women can be normal.

In Russia today, medicine turns a blind eye to the existing problem of the epidemic of tuberculosis, its drug-resistant forms. Diagnosis of extrapulmonary forms of the disease is at an extremely low level, and yet many women could successfully become pregnant if tuberculosis was detected in time and properly treated.

Anti-tuberculosis services in the regions of the country are very limited in funding, and even when a person comes for diagnostics, except for mantoux, diaskintest, and x-rays (excluding only pulmonary tuberculosis), no thorough diagnostics are carried out in cities far from Moscow and St. there are not enough qualified phthisiatricians-gynecologists. But tuberculosis of the female genital organs is often latent, sluggish, sometimes giving false-negative culture results (1 positive out of 3 negative).

If a woman constantly (or periodically in the second phase of the menstrual cycle) has subfebrile temperature body 37-37.5, weakness, allergic reactions, increased sweating, chronic salpingitis or salpingo-oophoritis, tests for hidden infections give negative results, persistent infertility due to obstruction of the fallopian tubes, the presence of uterine hypoplasia ("children's uterus") is also possible and the ongoing treatment does not give an effect; the doctor should recommend to be examined in an anti-tuberculosis gynecological department(better in St. Petersburg or Moscow) to exclude or confirm tuberculosis of the female genital organs.

Other reasons

Operations in abdominal cavity or pelvic organs - removal of appendicitis when it is ruptured, intestinal surgery, abdominal trauma, peritonitis, adhesions formed after any surgical intervention in the abdominal cavity
endometriosis
), intrauterine manipulations, hydrotubation of the fallopian tubes
Ectopic pregnancy in the past
Congenital malformations of the fallopian tubes
Tumors or polyps of the fallopian tubes

The risk of developing obstruction of the fallopian tubes due to inflammation according to clinical observations is:

After 1 episode of the inflammatory process in the uterine appendages, the risk of fallopian tube pathology is 12%
After 2 episodes - 35%
After 3 inflammatory processes - 75%

If a woman has an acute, aggressive inflammation of the uterine appendages, it may be necessary to remove both or one fallopian tube and, of course, the occurrence of a natural pregnancy becomes unlikely or impossible. How to treat obstruction of the fallopian tubes? Today, such a progressive direction in reproductive medicine as IVF, gives a chance to all women to know the joy of motherhood, even in the absence of fallopian tubes.

Symptoms, signs of tubal obstruction

With obstruction of the fallopian tubes, symptoms, signs may be absent, this pathology may not be reflected in any way on the general state of health and well-being. There are cases when a young woman is protected so as not to become pregnant during periods of life when they do not plan to have children, and when the desire to have a baby comes, the absence of pregnancy and the diagnostics performed indicate serious problems with the fallopian tubes.

This happens, unfortunately, not infrequently. The woman did not even know about such a pathology, because there were no symptoms of obstruction of the fallopian tubes and serious problems with health too. However, in chronic recurrent inflammatory diseases, as well as hydrosalpinx, many women experience the following signs obstruction of the pipes, which can be, with other pathological processes female genital organs:

How to determine how to check the obstruction of the fallopian tubes - diagnostics, examinations

To begin with, it is determined whether a woman has regular ovulation - conventional ultrasound or transvaginal (with a vaginal probe), a woman can also measure basal body temperature for several cycles on its own
Then the sexual partner should take a semen analysis

If the spermogram of a man is normal, and the woman has regular ovulation, normal structure genital organs, there are no signs of inflammation - most likely the cause of infertility is obstruction of the fallopian tubes. In this case, additional instrumental methods diagnostics.

Hydrosonography (echohisterosalpingoscopy) or ultrasound determination of the patency of the fallopian tubes

It is clear that conventional transvaginal ultrasound cannot determine the patency of the tubes. But a special UZGSS can give a general conclusion about whether the pipes are passable or not. The disadvantage of such a diagnosis is that it is not an accurate method, in contrast to diagnostic laparoscopy or GSG. However, this is a very fast and low-traumatic method that does not require anesthesia, or surgical intervention (as with laparoscopy), or radiation exposure(HSG), so the study is safe and can be done several times.

Hydrosonography occurs in this way - before the procedure, the doctor injects a sterile saline or other solution into the uterine cavity in order to straighten the walls of the uterus, to make them more visible on ultrasound. After that, the doctor determines where the injected fluid flows. When the tubes are patency, fluid flows from the uterine cavity into the tubes, and then into the abdominal cavity, and this can be seen by a specialist using ultrasound. If the fallopian tubes are impassable, then the uterus will stretch, and its cavity will expand. However, at partial obstruction, adhesions, other pathologies, it is impossible to visually see a picture of the state of the pipe with this method.

HSG - hysterosalpingography, X-ray of the uterus and tubes

This method of checking tubal patency is more informative than hydrosonography, but it is last years used much less frequently than before. For the diagnosis of tuberculosis of the female genital organs - this method is the most informative. The essence of the procedure is as follows: local anesthesia, the doctor introduces into the uterine cavity contrast agent and produces several x-rays after a certain time.

The pictures will show clear contours of the uterus, then as the fluid moves through the tubes, the fallopian tubes will also be visible, as well as the flow of fluid into the abdominal cavity when the tubes are patency. If the fluid has stopped in any part of the pipe, the doctor can record its obstruction. This procedure should be carried out in the 1st phase of the menstrual cycle in order to avoid irradiation of the egg.

Many physicians find this method also somewhat curative, since the injected solution has a flushing effect. However, today this diagnostic method has become less frequently used also because this procedure should be carried out only by an experienced doctor, and it also does not always bring reliable results(in 15-20% of cases there may be false results) when, due to spasm of the tube, the contrast agent does not enter the tubes.

Diagnostic laparoscopy

Today it is one of the most popular, informative, accurate methods of not only diagnosis, but also treatment. female infertility. This method detects not only a violation of the patency of the tubes, signs of obstruction of the fallopian tubes, but also other causes of infertility, such as endometriosis, ovarian cysts, polycystic ovaries, etc. The advantage of this method is the accuracy of the results and the possibility of eliminating some disorders - adhesions are dissected, foci are cauterized endometriosis. In order to determine the obstruction of the fallopian tubes through the cervix, the doctor injects a solution that penetrates the tubes and then into the abdominal cavity.

Fertiloscopy and transvaginal hydrolaparoscopy

Transvaginal hydrolaparoscopy is an examination of the condition of the female genital organs using a video camera, as in laparoscopy, only through a small incision in the vagina. Often this procedure is performed together with chromohydroturbation, and salpingoscopy, then this study is called fertiloscopy. To determine the causes of infertility, both fertiloscopy and transvaginal hydrolaparoscopy are as effective as conventional laparoscopy, only they are less traumatic and do not give complications.

How to treat obstruction of the fallopian tubes

All of the above methods for diagnosing tubal patency can be erroneous, not 100%, so do not despair, a woman always has a chance of becoming pregnant if she has a uterus and at least one tube and an ovary. Can be used modern methods anti-inflammatory, resolving therapy, as well as laparoscopy and IVF.

Tube obstruction is the cause of only 25% of all cases of infertility, in all other situations the impossibility of conception is caused by endometriosis, ovarian dysfunction, immunological incompatibility of partners (that is, a woman's allergy to her husband's sperm), as well as pathological disorders in the body of a man, or simultaneous problems in both partners.

When obstruction of the fallopian tubes is determined, before starting any treatment, the attending physician must make sure that this is the only main cause of problems with conception, and not a complex of other disorders in a woman and her man. Standard comprehensive examination married couple the following:

Does a woman ovulate regularly
Definition hormonal balance woman
Condition of the uterine mucosa
Analysis of the quality of the husband's sperm - )

If it is established that the production of follicles in a woman occurs regularly, the menstrual cycle is not disturbed, hormonal background also normal, the uterus is able to support the development of the fetus, the man has normal sperm quality, and instrumental methods diagnose obstruction, then specialists can recommend conservative and surgical treatment.

Conservative - this is a course of anti-inflammatory therapy when an inflammatory process of the uterine appendages is detected. It consists in: a course of antibiotic injections, a course of Longidaza injections, physiotherapy (and improving local blood circulation). This will be effective if the treatment is performed no later than 6 months after adnexitis and when a pronounced adhesive process has not yet developed.
Surgical treatment to restore tubal patency is indicated for a woman under 35 with regular ovulation in cases of partial obstruction.

And even such serious measures cannot guarantee success, since there is a high probability of developing an ectopic pregnancy, and restoring the patency of the tubes may not be enough if the activity of the fimbriae is impaired, or if the contraction of the fallopian tubes is impaired.

A woman after surgery on the fallopian tubes in the future - with positive test pregnancy, you should immediately consult a doctor to find out the location of the fetal egg. Since after inflammatory processes and surgery, the risk of ectopic pregnancy increases by 5-10 times.

In cases where several types of different diagnostics confirm complete obstruction, a woman who wants to have children should not waste time on different kinds treatment of obstruction of the fallopian tubes, and prepare for IVF. Today, this procedure is becoming more and more affordable both in terms of price (no more than 150 thousand rubles with all tests and diagnostics), and in terms of a large number available centers with experienced specialists and equipment for the operation. In doubtful cases or when the patency is impaired in one of the tubes, it is possible to use laparoscopy to eliminate, if possible, existing disorders, obstructions and adhesions.

By themselves, such operations do not guarantee either conception or normal course pregnancy, since the presence of a lumen does not mean at all that the egg will be able to move along them. Therefore, it is important to carry out further physiotherapeutic, absorbable treatment, as well as the elimination possible violations menstrual cycle, hormonal background.

With infertility due to obstruction of the fallopian tubes, the choice of treatment also depends on the age of the spouses, the degree of damage to the tubes, additional factors of male and female infertility, as well as the financial capabilities of the couple. Nevertheless, IVF is recognized today as the most effective, not very expensive and more successful, reliable method:

Obstruction of the fallopian tubes - folk remedies

What is the application of all folk remedies for the treatment of obstruction of the fallopian tubes - in use herbal remedies, medicinal plants in the form of tampons, douches, ingestion of infusions and tinctures. A woman should understand that if the fallopian tubes are clogged, such methods are unlikely to have an effect, and precious time will be lost.

For example, you cannot use medicinal plant as with obstruction of the tubes (see), since the likelihood of an ectopic pregnancy increases, although for infertility for other reasons it is recommended as a folk remedy.

And such a method as douching is recognized by gynecologists as not enough safe remedy self-medication, fraught with the development of vaginal dysbacteriosis, increasing the risk of developing inflammatory diseases genital organs and the risk of damage to the vagina, Bladder, cervix. (cm.).

Any medicinal herbs are the same drugs as pharmaceutical drugs, with possible toxic effects, side effects and contraindications, moreover, in our age of abundance allergic diseases, if available or , bronchial asthma, herbal preparations can cause severe allergic reactions.

Removal of the fallopian tube is an operation that is performed by many women in different ages. Sometimes doctors have to cut one, and sometimes two tubes at once. Statistics indicate that from 3 to 12% of women go through the procedure for removing appendages.

General state body, according to some experts, is not disturbed, because the fallopian tubes are only a transport system for the egg and sperm.

However, there are a number scientific papers, which prove the opposite point of view. The authors point out that menstrual irregularities, hormonal disruptions and other problems with the female reproductive system occur most often in those patients who underwent removal of the fallopian tubes.

Salpingectomy is a surgical intervention, the purpose of which is to remove the fallopian tube. Another name for the procedure is tubectomy. During its implementation, one or both appendages are removed. The procedure can be carried out important indications on an emergency basis. If the patient's life is not in danger, then tubectomy is planned.

Indications for salpingectomy:

Growth and development of the embryo in the cavity of the tube. On an emergency basis, the procedure is carried out when the embryo ruptures the appendage and the woman's internal opens.

If an ectopic pregnancy is formed a second time in the same tube.

Adhesions of the small pelvis that grow into tubes.

Ectopic pregnancy, which is not subject to conservative therapy(when the diameter of the fetal egg exceeds 30 mm). Concerning conservative method treatment of ectopic pregnancy, then it is implemented in order for the woman to be able to become pregnant on her own in the future. In this case, the fetal egg is pushed into the ampullar part of the tube, or a salpingostomy is applied to it.

The tube can be removed when the salpingostomy was unsuccessful and complicated by bleeding.

With severe deformities of the fallopian tube against the background or salpingitis. The tube is removed when its functionality cannot be restored.

Formation of pyosalpinx (accumulation of pus in the lumen of one or both fallopian tubes).

Planning for in vitro fertilization. Doctors in some cases insist on the removal of the fallopian tubes, citing the fact that IVF may be ineffective. The fact is that it is possible to reverse the flow of inflammatory exudate from the tubes into the uterine cavity and “wash out” the planted, but not implanted, fetal egg. In addition, if the pipes inflammatory process, then this can lead to toxic effects on the embryo. Sometimes it happens that the implanted embryo begins to take root in the uterus, but after some time, due to inflammation in the tubes, a woman has a miscarriage. Therefore, if a patient has hydrosalpinx for six months and she plans IVF, then the doctors insist on the preliminary removal of the fallopian tubes.

The presence of hydrosalpinx itself, without IVF planning, may be an indication for removal of the fallopian tube. This is especially true for those patients in whom the hydrosalpinx has an impressive size.

A combination of hysterectomy is possible (the operation is used for pathologies of the uterus, with malignant neoplasms ovaries, etc.) and tubectomy.

Most often, the doctor decides on the possibility of removing or preserving the fallopian tubes after or during diagnostic laparoscopy.

How the fallopian tubes are removed: the essence of the procedure

There are two types of fallopian tube surgery: laparoscopy and laparotomy. Laparoscopic intervention is a priority, it has a minimum set of contraindications, does not require extensive incisions to gain access to the fallopian tubes, and does not injure tissues and organs. In addition, patients after it recover quickly enough, and the rehabilitation period itself is much easier than after laparotomy.

If a tube rupture occurs against the background of an ectopic pregnancy, then this process is almost always accompanied by severe bleeding. development is not excluded hemorrhagic shock and other complications, up to death. Therefore, in such a situation, a woman can only do a laparotomy. In parallel, intensive infusion-transfusion therapy will be carried out. Only through the implementation emergency operation manages to save the woman's life.

Stages of laparotomy:

The introduction of general anesthesia.

Making an incision: according to Pfannenstiel (transverse incision above the womb) or an incision in the anterior wall of the peritoneum, below the umbilical zone.

Pumping out blood that has entered the abdominal cavity. The blood is collected in separate vials to be able to transfuse it later. However, autologous blood transfusion is available only if the patient is free of inflammation.

Extraction of the uterus and appendages in order to find the source of bleeding.

The imposition of a clamp on the isthmic part of the appendage, as well as on the mesentery. This allows you to stop the bleeding.

Cut off the fallopian tube.

Sanitation of the peritoneum and suturing.

During laparoscopy, the surgeon performs similar actions, but the blood pumped out of the peritoneum is not transfused to a woman.

If possible, the pipes are removed not completely, but partially.

Indications for resection of the fallopian tubes:

The presence of adhesions only in a small area of the fallopian tube.

An ectopic pregnancy that has just begun to develop.

benign tumor in one of the corners of the uterus.

The decision on whether it is possible to remove only part of the fallopian tube is made on an individual basis.

Contraindications for laparoscopy of the fallopian tubes

Laparoscopic method can not remove the fallopian tubes in the presence of the following contraindications:

Peritonitis.

Rupture of the fallopian tube, accompanied by severe bleeding.

Nervousness, irritability, tearfulness;

Painful sensations in the region of the heart;

Increased sweating;

Congestion of blood to the upper half of the body.

Symptoms tend to intensify before the next menstruation, and they are far from disturbing all women (they are observed in about 42% of cases).

About 35% of patients after 2-3 months after removal of the appendage notice menstrual irregularities. During the passage of ultrasound, they are diagnosed with an increase in the size of the ovary on the side where the fallopian tube was removed. Over time, it undergoes sclerotic changes, which is due to a violation of the flow of lymph and blood.

There is also an alternation of normal menstrual cycles with broken ones. Perhaps a decrease in the efficiency of the luteal body, the cessation of ovulation. However, such conditions are rarely observed.

From the side of the mammary glands, the following changes occur:

The glands become engorged in 6% of patients;

The breast becomes larger due to diffuse expansion of the lobules in 15% of patients;

Grows in size thyroid, its work is disturbed in 26% of patients;

It is also possible to develop the following symptoms: weight gain, the appearance of body hair, the formation of stretch marks on the skin.

These symptoms are especially pronounced in those women who have undergone surgery to remove both appendages.

In the early rehabilitation period the woman is shown the introduction of antibiotics, which helps to prevent the development of possible inflammation.

To minimize the risk of adhesion formation, the following measures are taken:

Doctors try to use laparoscopic surgery whenever possible, which is characterized by minimal trauma.

Before completion of the operation, absorbable barrier gels are introduced into the abdominal cavity. For some time they contribute to the fact that the surfaces of organs are at a distance from each other. This is a measure aimed at preventing adhesion formation.

The patient is raised the next day after the operation.

A woman is prescribed physiotherapeutic procedures: electrophoresis with iodine and zinc.

Calm walking and others moderate loads allow to prevent the formation of adhesions, or to minimize the risk of their formation.

After the operation, the woman is prescribed a course of antibiotics, subcutaneous injections aloe extract for 14 days. Possible appointment vaginal suppositories Longidaza.

For 6 months after the removal of the fallopian tubes, you need to without fail accept contraceptives to prevent pregnancy.

It is important to take good care of postoperative sutures, which will prevent their inflammation. You need to refuse to take a bath, you should wash yourself in the shower. In this case, the seams must be closed so that water does not get into them.

For a month after the operation, doctors recommend that patients wear slimming underwear.

Intimacy is under absolute ban during the first month after surgery.

stick to any special diet no need. However, you should temporarily exclude from your menu products that increase gas formation in the intestines. Therefore, you need to give up legumes, whole milk, yeast baked goods and pastries, cereals, meat and carbonated drinks.

After the operation, for several days, a woman may experience bloody issues from the vagina. This is normal, especially when a tube has ruptured or a hematosalpinx has been removed. It is not worth considering spotting as a complication of the operation, since they are explained by the reflux of blood into the uterus during or before the operation.

If the body quickly adapted, or there was a hormonal failure against the background of an existing disease, then a few days after the removal of the appendages, the woman may begin another menstruation. Moreover, this cycle can be longer than all previous ones. With minor blood loss, characteristic of the standard menstrual bleeding, you should not worry about this. If the blood loss is impressive, then curettage of the uterus and blood transfusion may be required.

early start menstruation after surgery is observed infrequently, in the vast majority of cases, menstruation comes on time. Although sometimes it happens that the cycle is restored for at least two months. This is also not a deviation from the norm. If after 60 days after the operation the cycle has not stabilized, then you need to contact the doctor. It is possible that the operation resulted in endocrine disorders that require professional correction.

Can you get pregnant without fallopian tubes?

Woman getting pregnant without fallopian tubes natural way can not. At the moment, doctors have not been able to develop an analogue of the fallopian tubes, although they have been trying to make them for many years. The first attempt to implant artificial appendages was carried out in the 70s of the last century. However, it was not successful, so it did not take root in medicine.

The only method that can help women conceive and bear a child without both fallopian tubes is in vitro fertilization.

If there is no fallopian tube, where does the egg go?

When both fallopian tubes are in place, they capture the egg released from the ovary into the abdominal cavity with fimbriae, and gradually move it into the uterus. It is also possible for a sperm to meet an egg in the tube and fertilize it. In the peritoneal cavity, the egg is able to exist for two days, after which it dies.

When a woman has one tube missing, the following options are possible:

Ovulation will not occur, the follicles will begin their reverse development. A similar situation is most often observed against the background of hormonal failure.

The egg will go into the abdominal cavity, and after 2 days it will die and be destroyed in it.

The egg will float in the abdominal cavity, it can reach the tube that has remained intact, and pass through it to the uterus.

Of course, it is much easier for fimbriae to capture the egg that is secreted by the ovary from the side of a healthy tube. If both appendages are removed from a woman, then the ovaries either undergo reverse development, or the egg will constantly die in the peritoneal cavity.

When can I plan to conceive after surgery?

A woman after the removal of one fallopian tube will be able to become pregnant on her own in 56-61% of cases. Moreover, this does not depend on the type of surgical intervention. Doctors point out that it is necessary to plan a pregnancy no earlier than six months after the operation. A number of experts do recommend that a woman wait 1-2 years, taking oral contraceptives. During this time, it will be possible to normalize the work of the neuroendocrine system and the body will be ready to bear the child.

After removal of the fallopian tubes, 42% of patients develop infertility, and in 40% of cases, the ovaries stop working with their former strength. Moreover, the risk of developing an ectopic pregnancy is 10 times higher. Therefore, IVF is the only method that allows a woman to conceive a child after the removal of the fallopian tubes.

Can tubal plasty replace them?

Gynecological surgeons may perform surgery to repair part of the fallopian tube, calling the procedure a fallopian tubeplasty. It is carried out after removal of the deformed portion of the appendage.

Concerning full recovery fallopian tubes, then this operation is not advisable. The fact is that a woman’s own appendages have the ability to contract so that the egg can move along them and reach the uterus. After plastic surgery, the pipes lose their ability to contract, which means that fertilization will be impossible. Therefore, the operation is carried out only when a small area of the appendage needs to be replaced.

Education: Diploma in Obstetrics and Gynecology obtained from the Russian State medical university federal agency health and social development(2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.

The fallopian tube is a paired organ in which sperm fertilizes the female sex cell. The fallopian tube can be removed due to an ectopic pregnancy.

Is it possible to get pregnant naturally without one tube? When one fallopian tube is removed, a woman's chance of pregnancy remains, although it is greatly reduced. This is due to the fact that the probability of maturation of the egg in the desired follicle is 50%. Conception is possible only if mobile cilia remain in the fallopian tube and it is passable. With inflammation, adhesions - conception does not occur.

If two tubes were removed, is it possible to get pregnant? When the patient's paired organ is completely removed, conception naturally becomes impossible.

The role of the fallopian tubes:

the site of fertilization of the egg by the sperm;
transportation of the zygote after the fusion of two germ cells.

Therefore, if both tubes are removed, then you will not receive a positive answer to the question of whether it is possible to get pregnant. So, as female and male germ cells have no place where they could come together and form a zygote.

Unfortunately, tubal transplants are also not performed due to complex structure and fragility. As a result, the only way out for women is in vitro fertilization (IVF).

Methods

If someone tells you that he managed to get pregnant with the removal of the fallopian tubes in a natural way, then he went to the IVF clinic. Without both tubes, you can get pregnant only with medical intervention.

Obstruction of the fallopian tubes or their absence are the main reasons for using in vitro fertilization. Scientists came up with a method primarily for women with problems in the uterine canals, and only then they began to use it to treat other causes of infertility.

The main goal of the procedure is to deliver the zygote directly into the uterine cavity. If there are no fallopian tubes, then the probability of getting pregnant with IVF is 60%. Sometimes the technique may differ, it all depends on whether the organ is completely removed or one tube is still left. If a woman has not completely removed the uterine canal, then it is important to monitor her so that there is no ectopic pregnancy.

ECO

The in vitro fertilization procedure consists of several stages.

Stimulation of ovulation. In order for several fertile female germ cells to form in the follicle, doctors select a special scheme for stimulation with drugs, individual for each patient.

To prescribe treatment, a survey, study of the anamnesis, determination of the ovarian reserve are carried out. While taking the drugs, strict control is carried out with the help of ultrasound diagnostics when the follicles reach required size, you need to move on to the next step.

Puncture of the ovaries. When the female sex cells reach fertility, the reproductologist prescribes an ovarian puncture. The day of the puncture is chosen depending on the ultrasound, treatment regimen, hormonal drugs and the degree of egg development.

The procedure is performed transvaginally under the strict control of ultrasound diagnostics and intravenous anesthesia. The puncture takes a couple of minutes. After the resulting material is placed in special containers with a multicomponent substrate (similar to a natural nutrient medium). On the same day, sperm are taken from the man and artificial insemination is carried out with the formation of a zygote.

Artificial insemination in vitro. All samples are carefully examined and the most suitable for fertilization are selected. Usually - class A and B. Next, reproductologists place the female reproductive cell and the male in one container with a special nutrient medium where fertilization takes place.

Cell culture (approximately five days). The zygote, which is in a special physiological saline stays there for a certain amount of time. The embryo is placed in an incubator where it begins to develop and divide. Most optimal time for embryo transfer from three to five days. On the fourth day, genetic mutations, chromosomal abnormalities can be identified and unusable zygotes can be weeded out.

Transfer of the zygote into the uterine cavity. Already selected, healthy cells are transferred to the body of the expectant mother. The reproductologist determines the date of transfer in the clinic individually, depending on the diagnosis and dynamics during therapy. Embryo replanting takes place under sterile conditions under the strict control of ultrasound diagnostics. The transfer process is painless and takes place with the help of a thin, flexible catheter.

If both fallopian tubes are removed, is it possible to increase the chances of getting pregnant? To do this, the reproductologist can implant several embryos at once. If there are still zygotes left after replanting, they can be stored in the clinic for the next use in case of an unsuccessful attempt. Embryos are frozen and stored in special containers.

Monitoring the health of a woman after the IVF program. To promote the implantation of the embryo after transferring it to the uterine cavity, the doctor prescribes a number of hormonal drugs and vitamins to increase the chance of a positive result.

Pharmacological agents are used only for preliminary analysis and under the strict control of ultrasound diagnostics, since hormonal preparations can have a big impact on hormonal levels.

After two weeks, a woman needs to take a pregnancy test by determining the level chorionic gonadotropin in blood. At a positive result 7 days later, ultrasound diagnostics are performed.

You can get pregnant without fallopian tubes if you use one of the new reproductive technologies. natural pregnancy possible only if one pipe is preserved and its patency is not disturbed.