Should I continue with tubal recanalization or opt for IVF if I have left-sided tubal blockage?

Patient's question:

Detailed medical condition and consultation purpose: Post-appendicitis pelvic inflammatory disease, ectopic pregnancy. Post-laparoscopic contrast study shows left fallopian tube obstruction, right fimbriae patency but not unobstructed, infertility. Please advise whether to continue tubal cannulation or proceed with IVF. What are the approximate costs for each option? What is the preferred approach?

Doctor's answer:

Hello: First, the cost is unclear! However, based on your situation, the best thing you need to actively consider is active treatment. Tubal blockage
(1) Tubal medication: When the fallopian tubes have mild adhesion or incomplete blockage, medication can be injected through the uterine cavity and fallopian tubes. The medication can be antibiotics, dexamethasone, and hyaluronidase dissolved in physiological saline. The volume of liquid depends on the degree of patency and is generally injected every 2-3 days after the menstrual period ends, until before ovulation. This can be repeated for 2-3 cycles. If ineffective, laparoscopic examination is recommended.
(2) Tubaloplasty: For cases where tubal inflammation does not improve after conservative treatment, tubaloplasty can be performed based on the results of hysterosalpingography, depending on the location of the blockage. There are four types: tubal adhesion separation, ostomy, end-to-end anastomosis of the obstructed part, and tubal cornual implantation, etc.

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