How to treat infertility after abortion? It is recommended to treat infertility caused by abortion

Ms. Chen, 34 years old, had not gotten pregnant for 5 years after abortion. External treatment was ineffective. After hysteroscopy, it was found that there was endometrial adhesion at the opening of the right fallopian tube, covering the opening of the fallopian tube. After separation of adhesions, the opening of the fallopian tube was clearly shown. The right fallopian tube was cannulated and fluid-permeated. It was initially blocked, but it was unblocked after pressure injection. The left fallopian tube was cannulated and fluid-permeated. It was initially unblocked but not smooth, but it became unblocked after pressure injection. After the operation, the IUD was placed and artificial cycle therapy was performed for 3 months to prevent adhesions in the uterine cavity again. She became pregnant 3 months after the IUD was removed.

Infertility after artificial abortion accounts for a certain proportion of infertility, and there is a trend of increase. There are two main causes of infertility after artificial abortion (blockage, poor patency), and the other is intrauterine adhesion. According to the author's recent statistics, abnormal patency of fallopian tubes accounts for 56.82% of infertility after artificial abortion, and intrauterine adhesion accounts for 60.71%, which is a very high proportion. As for other causes such as endometriosis and corpus luteum insufficiency after artificial abortion, the incidence is relatively lower than the first two. The first two are also the focus of treatment.

The following methods can be used in combination to treat fallopian tube patency: intramuscular injection of chymotrypsin; Chinese medicine can be used for blood circulation, stasis and stagnation, heat-clearing and detoxifying drugs, oral administration, enema, and abdominal external application. Tubal ventilation, fluid perfusion, and physical therapy can also be performed to achieve better results. In recent years, a few hospitals in China have used hysteroscopic catheterization and fluid perfusion to treat abnormal fallopian tube patency, and have achieved satisfactory results. The specific method is to insert a thin plastic tube into the fallopian tubes on both sides under direct vision of the hysteroscope, and inject gentamicin, dexamethasone, saline or procaine through each plastic tube. The drug has anti-inflammatory and adhesion-releasing effects, and the pressure during the injection of the drug can clear the blocked fallopian tube. Because the fallopian tube is directly injected and pressurized, the effect is significant, and the fallopian tubes of some patients can be cleared.

Treatment of intrauterine adhesions usually involves separating adhesions with a probe or a small curette. This method is performed without direct vision and is extremely blind, so the adhesion separation is not thorough and is prone to damage to the surrounding normal endometrium and myometrium tissue. Currently, the preferred method is to perform adhesion separation under direct hysteroscopy. Since adhesions are clearly visible, not only can the scope of adhesions be seen, but also the nature of adhesions can be identified, so the separation is thorough and does not damage the surrounding normal tissues. In this case, Ms. Chen had adhesions at the opening of the right fallopian tube, which were precisely separated under direct hysteroscopy to reveal the opening of the fallopian tube, and the blocked fallopian tube was cleared through intubation and fluid perfusion. This treatment effect cannot be achieved using general methods of separating adhesions.

It can be seen that hysteroscopy has a dual role in diagnosis and treatment of abnormal fallopian tube patency and uterine adhesions, and is an effective method for diagnosing and treating infertility after abortion. This operation is safe and painless. The operation is performed about 3 days after the menstruation is over.