Hydrotubation is a technique used to attempt to unclog the fallopian tubes, one of the most important causes of infertility in women. However, the intervention no longer exists in France but is still offered, for lack of other means, in certain underdeveloped or developing countries, particularly in Africa.
Definition: what is hydrotubation?
Hydrotubation consists of the instillation of an aqueous solution composed of physiological saline as well as antibiotics and anti-inflammatories in the fallopian tubes in order to unclog them.
When to hydrotubate?
Hydrotubation would be indicated in patients with tubal infertility, i.e. obstruction of the fallopian tubes. The fallopian tubes are tubes connecting the ovaries to the uterus. These play an essential role in reproduction because they allow the passage of spermatozoa to the oocyte itself expelled by the ovary and which is then in the tubal pavilion. Fertilization then takes place in the tubal ampulla. Finally, the embryo goes up the fallopian tube to settle in the uterine cavity. When there is tubal infertility, it means that the meeting between the spermatozoa and the oocyte is impossible. Obstruction of the fallopian tubes is one of the main causes of infertility in women.
Is it used in France?
No, hydrotubation is not used in France. The many French gynecologists contacted do not have any knowledge of this technique and very little information exists on this subject in the French scientific literature. This seems to be more focused on certain African countries where “65 to 85% of tubal infertilities are of infectious origin”according to this article scientist on tubal infertility in Africa. “The management of infertility in Africa is complex, due to the precariousness means of prevention and the difficulty of availability and accessibility of diagnostic and treatment methods. Thanks to technological prowess (laparoscopy, IVF), many women with tubal infertility have been able to procreate in developed countries. These techniques are slow to become popular in Africa because of their cost and availability.“, explain the authors, doctors in the gynecology-obstetrics department of the Biasa clinic in Lomé, Togo. In a publication Facebookthere Society of Gynecologists and Obstetricians of Burkina (SOGOB) confirm: hydrotubation “is no longer practiced in developed countries who use more medically assisted procreation techniques”.
Is it effective?
According to the article on Tubal Infertility in Africa, hydrotubation just like tubal insufflation have not shown their effectiveness. “The therapeutic value of these techniques is subjective but, in the absence of other means, they constitute first-line treatment. Their effectiveness has not been demonstrated in terms of intrauterine pregnancy rates. They are often used for lack of other means without any evidence of normality or tubal integrity.” In some cases hydrotubation could also be used in addition to tubal surgery. But according to an article published in April 2009 in the National Library of Medicine“surgery to correct tubal damage is undertaken to improve pregnancy and live birth rates. Postoperative hydrotubation (rinsing of the fallopian tubes) has been used to improve the outcome of tubal surgery. The review of the trials revealed that there was no not enough evidence to support the common practice of hydrotubation or this control laparoscopy after reproductive pelvic surgery. More research is needed“. Finally, according to another article published in the National Library of Medicine in January 2009, hydrotubation can “with a good selection of cases, be beneficial in resource-poor countries, especially in patients with incomplete tubal occlusion (bilateral perifimbrial adhesions) and in the context of treatment of unexplained infertility”.
Does it hurt ?
According to scientific studies and the testimony on social networks of women who have undergone this procedure in Africa, pelvic pain is very common. Another complication: vaginal bleeding may occur.
In France, what is the treatment for blocked fallopian tubes?
According to the National College of French Gynecologists and Obstetricians (CNGOF), no medicine is effective, only surgery or tubal plastic surgery can unclog the tubes. “It consists of opening the end of the fallopian tube and removing the adhesions (kind of veils that envelop the ovaries and the end of the fallopian tube) or removing the diseased area and bringing the two healthy ends closer together. This surgery is now practiced essentially under laparoscopy, that is to say without opening the belly, during a very short hospital stay.
Sources:
– Tubal infertility in Africa (MK FIADJOE, V. ADJENOU, JC KOLANI, KK EGAH (Lomé, Togo))
– Facebook publication of the Society of Gynecologists and Obstetricians of Burkina, SOGOB
– Postoperative procedures to improve fertility after pelvic reproductive surgery, National library of medicine
– Hydrotubation in the management of female infertility: results in low-resource settings, National library of medicine
– National College of French Gynecologists and Obstetricians (CNGOF)