Fallopian tube patency diagnosed by laparoscopic chromopertubation in women with polycystic ovarian syndrome and non-subfertile controls: a retrospective case-control study

Abstract

Background: Hyperandrogenism has been associated with tubal dysfunction. Previous studies have not used non-subfertile controls when assessing hyperandrogenic women through laparoscopic chromopertubation (LC), the gold standard for tubal patency testing. Methods: The objective of this retrospective study was to compare the results of LC between women with medication-resistant anovulatory polycystic ovary syndrome (PCOS, n = 202) and non-subfertile women with ovarian cysts (controls, n = 48). Results: There were no statistically significant differences between PCOS women and controls for the prevalence of bilateral tubal occlusion (2.5% versus 4.2%, respectively; p = 1.000) or overall rates for occlusion (7.4% of tubes assessed versus 6.3%, respectively; p = 0.828). More PCOS patients needed high pressure chromopertubation to demonstrate bilateral tubal patency than controls (12.4% versus 2.1%; p = 0.036). In the PCOS group, patients needing higher pressure to achieve patency demonstrated higher testosterone levels than women requiring typical pressure (0.66 ± 0.17 versus 0.47 ± 0.24 ng/mL; p = 0.001). Conclusions: For women with ovarian cysts and without subfertility, six percent of all Fallopian tubes are occluded. PCOS patients have similar rates of tubal occlusion, making these women a reasonable but more available control group for LC studies. Higher total testosterone levels were associated with higher LC pressures to demonstrate bilateral patency.

The Prevalence of Fallopian Tube Occlusion in Women with Polycystic Ovary Syndrome Seems Similar to Non-Subfertile Women: A Retrospective Cohort Study

“…In conclusion, our data found 5.6% of infertile women with PCOS to also have bilateral tubal occlusion, which is similar to the rate in non-subfertile women [ 25 ]. Coupled with the rate of about 6% for unilateral tubal occlusion in our patient populations, these data can be used for guiding PCOS women on the utility of Fallopian tubal assessment before ovulation induction.…”

“…Notably, data on non-subfertile women are rare. In one retrospective study which included young non-subfertile women with ovarian cysts, laparoscopic chromopertubation revealed bilateral tubal occlusion also to be 4.2% [ 25 ]. Another study focused on infertile women between 18 and 39 years of age with a BMI of ≥29 kg/m 2 and found bilateral tubal occlusion in 5/574 women (0.9%).…”

“…Several studies suggested that hyperandrogenism was associated with multiple risks for tubal dysfunction [ 25 , 33 , 34 ]. In contrast to PCOS-typical serological parameters, PCOS phenotype A was associated with an increased risk for tubal occlusion in our dataset, especially compared to phenotypes B, C and D ( Table 3 ), though the reduced risk in phenotype B was not statistically significant.…”

Are the Stage and the Incidental Finding of Endometriosis Associated with Fallopian Tube Occlusion? A Retrospective Cohort Study on Laparoscopic Chromopertubation in Infertile Women

“…Though commonly used, otherwise unexplained infertility is arguably an unsuitable control population, as unexplained infertility often relates to tubal disease that has been missed with conventional testing [23]. Similarly, polycystic ovary syndrome patients are at greater risk for altered tubal function and are in need of higher chromopertubation pressure to achieve patency [24]. Additionally, the retrospective study design must be considered a limitation.…”