Friday, June 08, 2012

Why hydrotubation is a waste of time and money

In the past, when reproductive technology was primitive, hydrotubation used to be a popular procedure for treating infertile women. The logic was simple. If the tubes were blocked, then “flushing” them with a liquid would result in opening them , as a result of the applied mechanical pressure. Often, doctors would add antibiotics , steroids and herbs to the fluid used for flushing, with the hope that these medicines would help to improve the efficacy of hydrotubation in improving tubal function.

These procedures were very popular with patients. They were simple to perform – and were cheap. They appealed to patients because they seemed to make a lot of sense – isn’t it best to treat a local problem with the help of local measures ?

Sadly, none of these techniques helped at all. This is hardly surprising. The fallopian tubes are far more sophisticated than a plumber’s pipe , and flushing them will not get the delicate cells which line the tube to start working properly. However, when there was nothing better to offer, hydrotubation was all poor doctors could perform, so the procedure remained popular for many decades.

Interestingly, some patients did get pregnant after hydrotubation. Of course, this was not as a result of the hydrotubation ; it was often just coincidental . However, doctors were happy to take the credit – which is why their delusion that hydrotubation was therapeutically effective was propagated for many years. ( Reading these medical journal articles today  is likely to make modern gynecologists cringe !)

In fact, in some poor countries, some doctors still use hydrotubation to treat infertility ! They use this for “ treating “ patients  with unexplained infertility; or perform it after doing an operative laparoscopy, to keep the “tubes open” !

Now, if hydrotubation was a harmless procedure, it really would not matter much. However, it does have major downsides. For one, it’s painful. Secondly, it’s often repeated many times. It wastes precious time – and patients get fed up and lose confidence in doctors when it does not work. Even worse, it can actually cause infertility, by introducing an infection into the pelvis, causing pelvic inflammatory disease and tubal blockade.

Hydrotubation is an obsolete procedure – and if your doctor advises it, please get a second opinion !

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7 comments:

  1. Hi. I am scheduled for the sessions. What would you profer to be the alternative solution for blocked fallopian tubes???

    ReplyDelete
    Replies
    1. Where are the tubes blocked ? cornual end ? fimbrial end ?
      How was the diagnosis made ?

      Read more at http://www.drmalpani.com/knowledge-center/articles/blocked-fallopian-tubes

      I need more information.

      Could you please send me your medical details by filling in the form at http://www.drmalpani.com/free-second-opinion
      so I can guide you better ?

      Taking treatment at a world-class clinic will maximize your chances of success and give you peace of mind you did your best !

      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba

      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com


      Delete
    2. What's the method or process that we can know, the tube is bloked or not? If not, hydrotubation is needed or not?

      Delete
    3. You need to do a HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm your uterine cavity is normal and your fallopian tubes are open).

      Delete
  2. Anonymous9:57 PM

    Hi I too have blocked tubes, well just one now. I recently had a cornual ectopic with right side wedge resection. (I think that's all of it)
    My husband and I have been trying for over 10 years. I've had 2 ectopics and 1 miscarriage. I was diagnosed with endometriosis and had a procedure done and the Dr was able to open my right tube at that time. That is the one I've lost with this last ectopic. I've been told IVF is my only option. Wondering if there is any hope. I'm 33, and realize the older I get the more I am considered "at risk". Just really don't know what to do and where to go from here. IVF would be great, it's just so expensive. Thanks for any advise.

    ReplyDelete
    Replies
    1. I agree you have tubal factor infertility. You can read more about this at www.drmalpani.com/knowledge-center/articles/blockedtubes

      I am sorry there is no way of repairing damaged fallopian tubes, as they cannot function normally
      even after surgery, since their inner lining ( the cilia) has been damaged.

      I agree that IVF would be your best treatment option
      as it would maximise your chances of conceiving quickly.

      Treatment takes about 20 days. Should I send you the treatment plan ?

      Our charges for an IVF/ICSI treatment cycle are $ 4000 only. This includes all
      medical treatments and procedures. Medicines would cost about US $ 1000 more. However, the cost of medications can vary, and
      depend upon how many injections you need for adequate superovulation.
      Included services in our IVF cost:

      Ovarian stimulation monitoring
      Anesthesia for egg retrieval
      Egg retrieval procedure
      Fertilization and culture of the eggs
      Embryo transfer procedure
      All physician, IVF lab, and facility fees associated with in vitro fertilization

      There is NO extra cost for doing ICSI or a blastocyst transfer !

      Excluded services - not included in our IVF costs:

      Pre-IVF screening tests
      Blood tests ( such as E2 levels)
      Embryo or sperm freezing or storage - these are optional services

      You can read about more about how we take care of our patients at http://www.drmalpani.com/ivf-treatment-at-malpani-ivf-clinic.htm

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !


      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  3. Hi, I am schedule for hydrobubation on Saturday by my Dr. Am currently on my third cycle of clomiphene(50g) and Zestup.
    Have been married for a year now and my Dr said I don't ovulate even when I feel cramps which I taught was from ovulation. Please I need your advice. Thanks

    ReplyDelete

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