Abnormalities Of Fallopian Tubes Research Articles

Radiological Evaluation of Uterine Tubes in Infertile Women with Previous Pelvic Surgery

Abstract Background: Infertility is a disease that affects 8%–12% of couples at their reproductive age. Tubal factors account for 20%–30% of infertility cases. Tubal infertility can be caused by infections, endometriosis, and complications from previous abdominopelvic surgery. Objectives: The objective of the study is to determine the impact of pelvic surgery on future fertility by examining the fallopian tubes for any potential damage using a hysterosalpingography (HSG) examination. Materials and Methods: A cross-sectional study was conducted at Nineveh Governorate, Iraq, in two clinics from March 2022 to September 2022 by examining 317 infertile females using HSG. The exam was done as part of an infertility workup. Results: The results revealed that the study included 317 infertile women patients with a mean age of 28.82 ± 6.9 years (range 17–49 years), of these, 184 patients (58.04%) with primary infertility, and 133 patients (41.95%) with secondary infertility. The years of infertility ranged between 1 and 20 years and a median of 4 years. The history of one or more previous pelvic interventions was recorded in 39 cases (12.3%). The prevalence of tubal abnormalities was noted in 23.1% of cases with previous pelvic intervention and 13.3% in other patients, with an odds ratio of 1.95 at a 95% confidence interval. Tubal abnormalities do not differ significantly according to the type of infertility, and the mean age of infertile women with tubal abnormalities is not statistically different from those with normal tubes. Conclusion: This study concludes that pelvic surgeries, particularly cesarean operations increase the risk of developing subsequent fallopian tube abnormalities and pelvic adhesions, which can lead to infertility.

A Comparison of Hysterosalpingographic Results in Individuals Experiencing Primary and Secondary Infertility: A Prospective Approach

Introduction: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used in process of different investigations. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. This study aims to compare the HSG results in a study population having primary and secondary infertility.
 Materials and Methods: We conceded a one-year prospective study at Islamabad Diagnostic Center in Islamabad, Pakistan after getting institutional review board approval. The study duration was from July 1, 2022 to June 30, 2023. Sample size was calculated using online software “Raosoft” which estimated it to 242. All the patients who gave informed consent and having primary and secondary infertility were enrolled. Demographics of the patients including age, duration of infertility, and the presence of tubal and uterine abnormalities, were collected by reviewing clinical notes and X-ray findings.
 Results: Among 242 enrolled patients with infertility, the ratio of primary infertility was 70.27% (n=170) and that of secondary infertility was 29.75% (n=72). In both the groups, fallopian tube blockage was observed as a major abnormality that affected 20.00% (n=34/170) of patients with primary infertility and 30.55% (n=22/72) of patients with secondary infertility. Unilateral tube blockage was observed in 26.47% (n=9/34) whereas, bilateral blockage was observed in 29.41% (n=10/34) patients with primary infertility. 23.52% (n=8/34) of patients got affected with Bilateral hydrosalpinx, whereas unilateral loculated spill was perceived in 8.82% (n=3/34) of. In patients with uterine congenital abnormalities, 5.88% (n=2/34) had a bicornuate uterus, 2.94% (n=1/34) had a unicornuate uterus, and 2.94% (n=1/34) had uterine didelphys.
 Conclusion: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. In this study, fallopian tube abnormalities were most predominant among barren women. So, taking deterrent actions and efficiently management of pelvic infections are indispensable in plummeting the manifestation of infertility resultant of the tubal issues.
 Keywords: Hysterosalpingography, Infertility, Subfertility, Tubal blockage
 

Prevalence of female genital tract disorders of ovaries and fallopian tubes in one-humped camels in Maiduguri, Nigeria using abattoir samples

The present study examined a total of one hundred and fifty (150) genital tracts of female dromedary camels (Camelus dromedarius) in Maiduguri abattoir for ovarian and fallopian tube disorders and different pathological lesions recorded were 27 cases, equivalent to 18.0% prevalence. Assessment and measurement of the genital tracts identified obvious gross lesions based on appearances, type of lesion, location and frequency of occurrence. Luteal cysts, catarrhal salphingitis, hemorrhagic cyst, ovarian hydro-bursitis and suspected case of granulosa cell tumour were detected. Follicular tube cysts both as unilateral and bilateral and as singles or multiples were also detected. Four of the cysts were observed on the left ovary, one on the right ovary and a multifocal was observed on both ovaries. The luteal cysts were thick walled. The luteal cysts were mostly seen in the left ovary representing 12 of the 16 cases while the remaining 4 cases were associated with the right ovary. A case of hemorrhagic cyst was recorded. Ovarian hydro-bursitis was recorded as a single case. A suspected granulosa cell tumor was observed in the left ovary. The study affirmed that ovarian and fallopian tube abnormalities are common findings in one-humped female camels although camels can withstand lots of stress associated with infectious and non-infectious diseases. These pathologies are possible causes of reduced fertility in one-humped camel in the study area.

Hysterosalpingography: a step up for dose reduction

To evaluate the efficiency of last image capture in interpreting a hysterosalpingogram (HSG) when compared to conventional spot views; to confirm its validity in showing pathology; to establish its use as the preferred method; and to decrease the radiation dose to the patient. The study population consisted of women aged ≥18 years. A standard technique was performed including additional five last image capture after each spot view. Every patient had two stacks of images, one with the exposure film and one with the last image capture. The images were interpreted separately (high-dose versus low-dose) and blindly by two radiologists with different levels of training assessing for uterine abnormalities, fallopian tube abnormalities, peritoneal spillage, and incidental findings. Inter-reading variability was calculated using Kohen's kappa. Discrepancies between exposure film and last image capture were detected in only a minority of cases for all variables. Except for the presence of strictures, there was at least substantial agreement between the readers and almost perfect agreement regarding peritoneal spillage and fallopian tube patency, both on exposure film and last image capture. Reduction in radiation dose without compromising the diagnostic efficacy of HSG is mandatory. If the study is of sufficient quality and deemed negative on last image capture, conventional spot view can be avoided. If further detail is required, standard spot views can still be obtained. Using last image capture instead of spot films has the potential to reduce the overall radiation dose by up to 78%.

ROLE OF CONVENTIONAL HYSTEROSALPINGOGRAPHY IN EVALUATION OF FEMALE INFERTILITY

Background: Infertility is a major problem throughout the world. The cause can be multifactorial ,now a days many couples are seeking medical help for infertility. Hysterosalpingography plays an important role as part of the female infertility workup. A Materials And Methods: retrospective study was done in the department of Radiodiagnosis of a rural tertiary care hospital, Kuppam,India. All patients who were referred for hysterosalpingography study as part of infertility workup between June 2020 and December 2021 to the department of Radiodiagnosis were included in the study. A total of 100 patients are included in the study .Out of Results: 100 HSG examinations 61% were normal and the remaining 39%cases were abnormal .Tubal abnormalities were most common constituting 25% of total cases. Uterine abnormalities were about 14% . Conclusion: HSG is a very useful diagnostic tool in evaluating female infertility occuring due to structural abnormalities of uterus and fallopian tubes, there by aiding in patientsinfertility management. It is lesser invasive and cost effective compared to laparoscopy

Diagnostic Accuracy of Sonosalpingography for Assessing Tubal Patency in Women with Infertility Taking Laparoscopy as Gold Standard

Background: Infertility is defined as the failure to conceive after 1 year of unprotected sexual intercourse in women less than 35 years of age and 6 months in women older than 35 years [1, 2]. It affects 10 to 15 % of the couples [1]. Abnormalities of fallopian tubes account for 35 to 40 % of the cases of infertility [3]. Sonosalpingography is a non-invasive, safe and cost- effective diagnostic technique which provides reliable diagnosis of tubal patency [4]. Objective: To evaluate the diagnostic validity of Sonosalpingography as a tubal patency test in infertile women using laparoscopy as gold standard. Methodology: This study was carried out at the Radiology Departments of Khyber Teaching Hospital and Kuwait Teaching Hospital in Peshawar. We used the WHO method for sample size by taking the prevalence of tuboperitoneal factors as 30%, sensitivity 72.9%, specificity 81.22%, margin of error 12%, and 95% confidence interval. It was a cross-sectional study that lasted for 6 months and assessed a total of 178 patients. Additionally, a non-probability, sequential sampling strategy was utilized to acquire the sample. Results: Our patients aged between 18-45 years, out of which 30% of the participants aged 18 to 25years, 55% were between 26 and 35years, and 15% were between 36 and 45years. Standard deviation was 1.26, with a mean age of 27. The data collected from both the diagnostic tests was analyzed, diagnostic accuracy of Sonosalpingography was calculated as a sensitivity of 81%, specificity of 76%, positive predictive value of 90%, negative predictive value of 60%, and diagnostic accuracy of 79%. Conclusion: According to the results of our study, sonosalpingography is a very helpful supplemental diagnostic tool for evaluating tubal disease in patients with infertility, though direct laparoscopic assessment is the gold standard. Sonosalpingography and laparoscopy can be used to evaluate patients with secondary infertility. This spares the patient from being exposed to radiations and the discomfort of contrast administration in HSG. Keywords: Diagnostic Accuracy, Sonosalpingography, Tubal Patency, Infertility, Laparoscopy

Conception and pregnancy outcome after laparoscopic treatment of subtle distal fallopian tube abnormalities in infertile women: a prospective cohort study

Research questionWhat are conception rates and pregnancy outcomes after laparoscopic treatment of subtle distal tubal abnormalities among infertile women, and which factors relate to natural conception? DesignProspective cohort study (n = 234) conducted in a single fertility referral centre between January 2017 and December 2018. Subtle abnormalities included fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis and accessory fallopian tube. Pregnancy outcomes were followed-up annually until 36 months. ResultsOne hundred and nine patients conceived naturally (natural conception rate 46.6%), and 59 patients conceived after IVF. Term live birth rate of the natural conception group was significantly higher than the IVF conception group (86.2% versus 71.2%, chi-squared = 5.625, P = 0.018). Preterm birth (11.9% versus 0%, P = 0.001) and multiple pregnancy rates (27.1% versus 0%, P < 0.001) of the IVF conception group were significantly higher than the natural conception group. Patient age (hazard ratio = 0.917, 95% CI 0.870 to 0.967, P = 0.001), duration of infertility (hazard ratio = 0.846, 95% CI 0.740 to 0.966, P = 0.014) and concurrent types of subtle abnormalities (hazard ratio = 0.636, 95% CI 0.416 to 0.970, P = 0.036) were factors associated with natural conception. ConclusionsLaparoscopy is an effective treatment for infertile patients with subtle abnormalities, especially for young patients with a short infertile period and at most two types of subtle abnormalities. For older women, a long infertile period and more than two types of subtle abnormalities, IVF may be more suitable after laparoscopic diagnosis.

O-057 The pregnant outcome after laparoscopy treatment for subtle distal fallopian tube abnormalities in infertile population: a prospective cohort study

Abstract Study question What is the the pregnancy outcome after laparoscopy treatment for subtle distal fallopian tube abnormalities and the factors related with natural pregnancy. Summary answer The natural pregnancy rate is 46.58% after laparoscopy and patients' age, duration time of infertility and concurrent number of abnormalities are related with natural pregnancy. What is known already Subtle distal fallopian tube abnormalities are a group of diseases that are characterized by subtle variations in tubal anatomy including fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis, and accessory fallopian tube. The prevalence of subtle distal fallopian tube abnormalities is high in infertile women.This group of diseases is highly related to endometriosis, especially its early stage, and may indicate fimbrial abnormalities in endometriosis. Study design, size, duration This was a prospective cohort study conducted in the Reproductive Medicine Center of an university-affiliated teaching hospital from January 2017 to December 2018. Participants/materials, setting, methods 234 patients with subtle distal fallopian tube abnormalities were included. Laparoscopies were performed by four senior reproductive surgeons who were familiar with the diagnostic criteria and surgery treatment for subtle abnormalities. The fallopian tube abnormalities were corrected and endometriosis was treated by either electrical ablation for peritoneal lesions or endometrioma excision.The participants were followed up by phone every 12 months for pregnancy outcome until 36 months after surgery. Main results and the role of chance 167 patients conceived after surgery(clinical pregnancy rate 71.37%). 109 patients conceived naturally (natural pregnancy rate 46.58%) and 59 patients conceived after in IVF（One case conceived naturally after live birth after IVF, four cases conceived naturally twice) . The average time for natural conception after surgery is 8.36±7.47 months. 51.4% of natural pregnancy occurred within 6 months and 79.8% occurred within 12 months.Among the 109 naturally conceived patients, there were 94 cases of live birth, 13 cases of natural abortion (natural abortion rate 11.92%) and 2 cases of ectopic pregnancy (ectopic pregnancy rate 1.83%). No preterm birth, multiple pregnancy or birth defects were reported in this group.The patient age(HR = 0.917,95%CI 0.870-0.917,P=0.001), duration of infertility(HR = 0.846,95%CI 0.740-0.966,P=0.014) and concurrent number of subtle abnormalities (HR = 0.636,95%CI 0.416-0.970,P=0.036) are the factors associated with natural pregnancy. The type of subtle abnormalities, type of infertility, body mess index, concurrent endometriosis, uterine cavity abnormalities and myoma are not related with natural pregnancy. Limitations, reasons for caution Not all kinds of subtle distal abnormalities are included such as paratubal cyst is excluded from the study. Not all the patients had the test of ovarian reserve such as AMH, antral follicle count and FSH level, so we couldn’t evaluate the relationship between ovarian reserve and natural pregnancy. Wider implications of the findings This is the largest clinical study that investigated the pregnancy outcome of subtle fallopian tube abnormalities in the infertile population.Laparoscopy surgery is an effective treatment for infertility patients with subtle distal fallopian tube abnormalities, especially for the young, short duration time of infertility and ≤2 types of subtle abnormalities. Trial registration number ChiCTR2000029095

Diagnostic hysterolaparoscopy: An important tool in evaluation of female infertility, in beneficiaries of ESI scheme in Eastern India

Background: The WHO estimates that 60–80 million couples worldwide suffer from infertility and the overall prevalence of the primary infertility in India is 3.9–16.8%. As usual tests and examinations are unable to appreciate majority of pelvic pathology in infertile women, diagnostic laparoscopy has become an essential part of infertility evaluation. Diagnostic laparohysteroscopy (DHL) gives the opportunity to directly visualize and manipulate pelvic organs which allow accurate diagnosis and give an option to treat at the samesitting. Aims and Objectives: The aims of this study were to detect pelvic organ abnormalities by diagnostic hysteroscopy and laparoscopy in the evaluation of female infertility in a tertiary care hospital. Materials and Methods: This cross-sectional observational study recruited 50 patients who attended the infertility clinic during 1 year period as per inclusion and exclusion criteria. Those with male factor and endocrine abnormality were excluded from the study. The patients having abnormal hystero-salpingography (HSG) findings and those who in spite of having normal HSG finding, did not conceive even after three cycles of ovulation induction, underwent DHL. Results: Out of the 50 patients, 35 (70%) suffering from the primary and 15 (30%) suffering from the secondary infertility. The mean age of the study population was 29.5±5.3 years. Most of the cases presented with 3–6 years of infertility. The most common reported laparoscopic abnormality was ovarian in 58% cases, followed by 56% of pelvic and peritoneal abnormalities, 44% tubal factor abnormality, 36% having endometriosis at different stages, and 30% having uterine abnormality. Conclusions: Hystero -laparoscopy has good diagnostic accuracy in evaluating pelvic pathologies. The combination of hysteroscopy with laparoscopy done in a single setting improves the detection rate of abnormalities of uterus, fallopian tubes, ovaries, and pelvic peritoneum.

Undescended ovary without abnormal development of uterus and urinary system: a report of four cases

BackgroundCongenital anatomic abnormalities of fallopian tubes and ovaries are rarely reported. Herein, we describe four cases of undescended ovary during laparoscopic surgery with abnormal anatomy of fallopian tube, yet without abnormal uterine development and urinary system abnormalities, which are analyzed by their clinical features and effects on reproductive function.Case presentationFor the patients with undescended ovary, the location of unilateral or bilateral upper poles of the ovaries were usually much higher than that of the bifurcation of the common iliac vessel, and the fallopian tubes at the same side opened in the para-colonic sulcus. Among these four patients, two patients had primary infertility, one patient had tubal pregnancy rupture and bleeding, and one patient had uterine leiomyoma. The development of uterus was normal in all cases, and there was no abnormal development of urinary system. During the infertility examination, the fact that fallopian tubes lifted up in hysterosalpingography (HSG) might be regarded as an indicator of possible undescended ovary. The pelvic ultrasonography examination was of limited use in diagnosing undescended ovary.ConclusionLaparoscopy is the gold standard for the diagnosis of undescended ovary. When there is periodic post-sacral spinal pain, MRI or HSG can be used for diagnosis of undescended ovary.

Prevalence of subtle distal Fallopian tube abnormalities and their association with endometriosis in infertility patients: a prospective cohort study

Subtle distal Fallopian tube abnormalities comprise a group of diseases that are characterised by subtle variations in tubal anatomy. This prospective cohort study investigated the prevalence of subtle distal Fallopian tube abnormalities in the infertile population and their relationship with endometriosis. It was conducted in a single fertility referral centre between January 2017 and December 2018 and included all infertile patients who underwent laparoscopy. Subtle distal Fallopian tube abnormalities included fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis, and accessory Fallopian tube. A total of 876 patients were enrolled in the study, and 251 cases (28.65%; mean age: 29.4 ± 4.7 years) were diagnosed with subtle tube abnormalities. A total of 179 of these cases presented only one type of abnormality, 62 presented two types of abnormalities, and 12 presented three types. Tubal fimbrial agglutination composed the largest group (62.2%; n = 156), followed by tubal diverticula (26.3%; n = 66), fimbrial phimosis (25.5%; n = 64), tubal accessory ostium (15.5%; n = 39), and tubal accessory ostium (15.5%; n = 39). An accessory Fallopian tube was the least common abnormity (4.8%; n = 12). A total of 70.9% (178/251) of the women with subtle tubal abnormalities had endometriosis. The prevalence of subtle distal Fallopian tube abnormalities in the stage I-II group was significantly higher than in the stage III-IV group (57.3% [149/260] vs. 20.9% [29/139]; p < 0.001). These findings indicate the high prevalence of subtle distal Fallopian tube abnormalities in the infertile woman. This group of diseases is highly related to endometriosis and may indicate fimbrial abnormalities of endometriosis.

Characteristics of magnetic resonance imaging and clinical etiology of ovarian infertility

Objective: To analyze the characteristics of magnetic resonance imaging (MRI) and clinical etiology of ovarian infertility. Methods: The data of infertile women who underwent 3.0T MRI and magnetic resonance hysterosalpingography (MR-HSG) examination in the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2017 to March 2020 were collected. The ovarian factors of infertility, as well as the abnormalities of bilateral fallopian tubes and uterus, were evaluated. Etiologies assessed by MRI were finally confirmed by hysteroscopy, laparoscopy, surgery, or a comprehensive clinical diagnosis. Results: Among 1 351 patients, 1 296 cases were eligible and included for further analysis. Evaluated by MRI and MR-HSG, 494(38.12%) cases had ovarian abnormalities, including 239(48.38%) cases of ovarian endometriosiss, 116(23.48%) cases of polycystic ovary syndrome (PCOS), 37(7.49%) cases of diminished ovarian reserve (DOR), 33(6.68%) cases of ovarian mass, 28(5.67%) cases of ovarian injury, and 41(8.30%) cases who had at least two kinds of ovarian diseases. Unilateral and bilateral ovarian abnormalities accounted for 52.02% (257/494) and 47.98%(237/494), respectively.In total, 453 of 494(91.7%) patients had only one kind of ovarian disease. Among the 494 patients, 103(20.85%) cases had abnormal ovary with normal uterus and fallopian tubes, and the other 391(79.15%) cases had abnormalities not only in ovary, but in fallopian tube and/or uterus. Conclusion: Infertility-related ovarian diseases have certain characteristics of MRI findings. 3.0T MRI is useful for comprehensive analysis of etiology in ovarian infertility. Combined with MR-HSG, it provides one-stop assessments of the pelvic factors in female infertility.

Female Factors of Infertility in a Couple

The problem of infertility is relevant to the whole world, that is explaned both by the prevalence (at least 50 million couples on the planet are diagnosed) and by the enormous medical, ecoomic, social and psychological significance. Another important aspect of infertility is the heterogeneity of its causes – about 40% of infertile marriages are caused by the female factor, 35% – male, 20% – a combination of male and female factors and 5% – have no identified factor. In 2019, the American Collegue of Obstetricians and Gynecologists updated the guidelines for the timing and scope of examinations of infertile couples. In particular, if a woman is 35–40 years old, examination and elimination of the probable factor of infertility should be started after 6 months of non-pregnancy, and in the case of age older than 40 years – immediately after the couple’s accost. The expected tactics should not be used if the patient has oligo- or amenorrhea, known uterine and fallopian tube abnormalities, grade III or IV severity of endometriosis, and the couple has known male infertility factors. Ovulation disorders as a factor of infertility include hypothalamic syndrome, polycystic ovary syndrome, premature ovarian failure and hyperprolactinemia, which differ in the content of gonadotropic hormones and ovarian hormones. The adhesion process of the pelvic organs, which restricts the transport of sperm and fertilized egg through the fallopian tubes, is a consequence of endometriosis and inflammatory diseases caused mainly by sexually transmitted pathogens. Endometriosis, in addition to the formation of adhesions in the pelvic cavity, which is characteristic of stage III and IV of the disease, is also a factor in infertility due to elevated concentrations of prostaglandins and proinflammatory cytokines, failed endometrial reciprocity. Among the uterus abnormalities in the violation of fertility are the uterine membrane, leiomyoma with submucosal localization of the node and uterine synechiae. As part of a comprehensive examination of patients with infertility, it is necessary to take into account the study of thyroid function.

Fallopian tube abnormalities in uterine serous carcinoma

ObjectiveUterine serous carcinoma (USC) is presumed to arise from endometrial intra-epithelial carcinoma (EIC), whereas tubo-ovarian high-grade serous carcinomas have similar precursor lesions in the Fallopian tube, i.e. serous tubal intra-epithelial carcinoma (STIC). The presence of Fallopian tube abnormalities and their clonal relationship to the concurrent USC was investigated. MethodsIn this multicenter study, all patients treated for USC between 1992 and 2017 were retrospectively identified. Histopathological diagnosis of USC, EIC and STIC was revised by an expert pathologist. Additionally, all Fallopian tube sections were immunohistochemically stained (p53 and Ki-67). Fallopian tube abnormalities were classified as either p53 signature, serous tubal intra-epithelial lesion (STIL) or STIC. The USCs and Fallopian tube abnormalities were analyzed by targeted next-generation sequencing. ResultsIn 168 included patients, Fallopian tube abnormalities were found in 27.4% (46/168): p53-signatures in 17.9% (30/168), STILs in 3.0% (5/168) and STICs in 6.5% (11/168). In subgroup analysis, STICs were found in 9.5% (11/115) of patients with at least one section of the fimbriated end embedded. Next-generation sequencing showed identical TP53-mutations in the STIC and corresponding USC. ConclusionsIn conclusion, the presence of Fallopian tube abnormalities was shown in a high percentage of patients with USC, representing either true precursor lesions or metastasized disease.

Fallopian tube microbiota: evidence beyond DNA.

To determine whether cultivation-dependent and -independent analyses identifying fallopian tube bacteria were associated with visually observable microbial cells in situ using scanning electron microscopy. Fallopian tubes were collected from pre- and postmenopausal women undergoing salpingectomies for benign disease or as prophylaxis. Fresh fallopian tube samples were processed for scanning electron microscopy to characterize fallopian tube ultrastructure. Histopathology was used to exclude fallopian tube abnormalities and for menstrual cycle staging of the endometrium. Scanning electron microscopy revealed observable microbial cells in fallopian tube samples. In the absence of inflammatory pathology, the fallopian tube harbors a visually observable microbial population, which correlates with cultivation-dependent and -independent data, further refuting the sterility of this anatomical niche.

Infections of the genital tract in women with verified laparoscopy of the pathology of the fallopian tubes and normal laparoscopic results

Introduction. Pipe and peritoneal factors are important causes of infertility and inflammatory diseases of the pelvic organs (PID). It is well known that Neisseria gonorrhoeae and Chlamydia trachomatis are etiologic agents of pelvic inflammation leading to infertility. There is a very limited number of publications about which representatives of sexually transmitted infections (STIs) or other microorganisms can be found in the fallopian tubes during reconstructive plastic surgery. Knowledge in this area is necessary for the proper selection of antibiotic therapy during and after operations. The purpose of our study is to determine the microbial landscape of the contents of the fallopian tubes in infertile patients with a tubal peritoneal infertility factor diagnosed during laparoscopy and normal uterine tubes. Materials and methods. 22 women with infertility were included in the study. 12 of them (the main group) had tubal peritoneal pathology, 10 women had no pathology of the fallopian tubes (control group). The average age of patients in the first group was 25 years (20-29), in the control group - 31 years (20-36). For all women, laparoscopy was part of the infertility survey. In the 1 st group, the changes in the fallopian tubes according to the type of fibrosis, hydrosalpinx or adhesions in the region of the periampulal or fimbrial part were identified. During laparoscopy, the fallopian tubes were washed with 2-4 ml of saline immediately after laparoscopic and laparoscopic instruments. Through the lateral trocar, the material was taken from the fallopian tubes using a bacteriological loop to perform bacteriological inoculation. Identification of the DNA of the pathogens was carried out by the polymerase chain reaction method according to the instructions. Identification and sensitivity determination of the isolated cultures was performed using an automatic bacteriological analyzer Vitek 2 Compact 30. Results. In all women without an identification of STIs and PID in the history and absence of abnormalities of the fallopian tubes in laparoscopy (control group), we did not find any microorganisms in the fallopian tubes. We did not detect C. trachomatis, N. gonorrhoeae or Trichomonas vaginalis in the fallopian tubes. However, we found twice Ureaplasma urealyticum in the fallopian tubes (16.7%), while in the control group this microorganism was also detected once. An important feature of salpingitis is extensive tissue remodeling, leading to chronic effects, such as scarring and obstruction, during which STIs and other microorganisms are eliminated by the immune system. In this study, we identified twice in the fallopian tubes of U. urealyticum. Perhaps U. urealyticum persists after antibiotic therapy and selective elimination of the main pathogens, since certain antibiotics affect the cell wall that is absent in this microorganism.

Fallopian Tube Abnormalities and Associated Surgical Interventions

Fallopian Tube Abnormalities and Associated Surgical Interventions

Fallopian Tube Abnormalities and Associated Surgical Interventions

Fallopian Tube Abnormalities and Associated Surgical Interventions

“Tubal Ostium Sunshine”: Hysteroscopic Sign of Chronic Salpingitis

Fallopian tube abnormalities including tubal occlusion, acute and chronic salpingitis, hydrosalpinx, peritubal adhesions, and salpingitis isthmica nodosa are major causes of female infertility, accounting for 30% to 40% of all cases. A tube may be obstructed as a result of inflammation or a previous surgery. Most commonly, fallopian tube occlusion is due to an infection such as pelvic inflammatory disease, typically caused by a sexually transmitted agent such as Chlamydia trachomatis or Neisseria gonorrhoeae.

Uterine and tubal anatomical abnormalities in infertile women: diagnosis with routine hysterosalpingography prior to selective laparoscopy

Objective: To assess the findings and usefulness of hysterosalpingography as a routine investigation in the fertility workup prior to selective laparoscopy. &#x0D; &#x0D; Design: Descriptive retrospective study.&#x0D; &#x0D; Setting: A university hospital in the north of Jordan.&#x0D; &#x0D; Subjects: All hysterosalpingographies performed in the period between 1st January and 31 December 2008. &#x0D; &#x0D; Outcome measures: Detection of uterine and fallopian tube abnormalities and their correlation with laparoscopic findings.&#x0D; &#x0D; Results: During the study period, 281 infertile women underwent hysterosalpingography with no post procedural complications. The mean (SD) age was 31.5 (5.91) years. Mean (SD) duration of infertility was 4 (3.44) years. Infertility was reported as primary and secondary by 119 (42.3 %) and 162 (57.6 %), respectively. Altogether 281 patients and 562 tubes were examined. Of those, 402 were patent and 160 occluded. There was only one woman in whom peritubal adhesions were diagnosed. Because of hysterosalpingographically diagnosed tubal occlusion, 46 women (16.4 %) were referred for laparoscopy. Eight (17.3%) of them were treated with unilateral salpingectomy and 28 (60.8%) with bilateral salpingectomy. Salpingolysis was performed for 7 (15.2%) women, and 3 (6.7%) women had untreatable adhesions. The concordance was 71.7%. The sensitivity of HSG was 80%, the specificity 50%, the negative predictive value 61% and the positive predictive value 71%. Of the total of 281 women, 30 (10.7%) conceived within 1 - 11 months after the hysterosalpingography.&#x0D; &#x0D; Conclusions: The very high abnormal predictive value of hysterosalpingography in the diagnosis of tubal occlusion suggests that this procedure could be performed as a screening examination.