Proximal fallopian tube occlusion: diagnosis and treatment with transcervical fallopian tube catheterization.

Abstract

Transcervical fallopian tube catheterization (TFTC) was performed in 22 infertile patients with bilateral fallopian tube obstruction and a mean duration of infertility of 3.3 years. A high prevalence of previous ectopic pregnancy (n = 8, 36%), tubal ligation and/or reconstruction (n = 5, 23%), spontaneous or therapeutic abortion (n = 6, 27%), and previous intrauterine device use (n = 14, 64%) was noted. The authors successfully catheterized 40 (98%) of 41 tubes without serious complication and visualized the distal tube in 36 (88%) of 41 tubes. Free spill in at least one tube was seen in 17 (77%) of 22 patients. Nineteen patients had a history of previous laparoscopy or laparotomy for tubal disease, in 16 of whom laparoscopic results were available for review. Retrospectively, in 15 (94%) of 16 patients all clinically relevant abnormalities would have been detected by means of TFTC alone. Five patients conceived, three with intrauterine and two with ectopic pregnancies. Patients with intrauterine pregnancies had normal-appearing tubes after TFTC, while those with ectopic pregnancies had residual tubal abnormalities after recanalization. TFTC is a safe, accurate diagnostic procedure that provides more information than hysterosalpingography and, in most cases, as much or more information about the fallopian tubes than laparoscopy.

Tubal evaluation in the investigation of subfertility: A structured comparison of tests

“…No major complications have been reported with selective salpingography and tubal catheterisation, 36–38 and most minor complications associated with selective salpingography and tubal catheterisation can be managed conservatively 39 (Table 2).…”

“…Tubal perforation has been reported in 0% to 10% of cases. 37,38 However perforations normally require no additional treatment.…”

The role of ambulatory hysteroscopy in reproduction

“…There is a hypothesis that PTB recurs in many women shortly after TC has been performed 30. However, follow-up HSGs after TCs confirm patency in 63–88% of women who have not conceived at 3–6 months 27. Also, a significant proportion (43%) of conceptions occur after 12 months following treatment.…”

Evidence Based Diagnostic Approach to Tubal Factor Infertility

“…For proximal tubal obstruction, transcervical tubal cannulation with tubal flushing is a reasonable first approach. 9 Surgical techniques for tubal repair, such as salpingostomy or fimbrioplasty for distal tubal obstruction, can provide good results. Still, tubal factor remains a major indication for in-vitro fertilization and embryo transfer, which bypasses the tubal problem altogether.…”