Recanalization of Proximal Fallopian Tube Obstruction in the Treatment of Infertility.

Priya Mody, Gloria Salazar, Maureen P Kohi
Author Information
  1. Priya Mody: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
  2. Gloria Salazar: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
  3. Maureen P Kohi: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Abstract

Infertility affects approximately 15% of patients worldwide, with up to 40% of cases attributed to tubal disease, and up to 25% of those being proximal fallopian tube obstruction (FTO). Evaluation of tubal patency can be performed via laparoscopic chromopertubation, hysterosalpingography, or hysterosalpingo-contrast-sonography (HyCoSy). In patients with proximal tubal obstruction, fallopian tube recanalization (FTR) can result in up to 100% technical success rate with pregnancy rates of 12.8 to 51%. More pregnancies occur when oil-soluble contrast media are used versus water-soluble contrast media. Complications of FTR are rare and include tubal perforation, ectopic pregnancy, and pelvic infection. Reocclusion of fallopian tubes may occur in 20 to 50% of patients; however, FTR may be repeated in these cases. Overall, FTR is underutilized in the treatment of infertility secondary to proximal FTO and it can obviate costly and time-consuming assistive reproductive techniques such as in vitro fertilization in some patients, as well as decreasing physical and emotional stress.

Keywords

References

  1. Obstet Gynecol. 2018 Jun;131(6):e172-e189 [PMID: 29794678]
  2. Clin Biochem. 2018 Dec;62:2-10 [PMID: 29555319]
  3. CVIR Endovasc. 2023 Mar 13;6(1):13 [PMID: 36912985]
  4. Fertil Steril. 2018 Sep;110(4):754-760 [PMID: 30196973]
  5. Insights Imaging. 2012 Oct;3(5):475-83 [PMID: 22802083]
  6. J Minim Invasive Gynecol. 2005 Mar-Apr;12(2):150-2 [PMID: 15904619]
  7. J Obstet Gynaecol Can. 2018 Oct;40(10):e723-e733 [PMID: 30390951]
  8. Cureus. 2022 Nov 1;14(11):e30990 [PMID: 36475176]
  9. J Int Med Res. 2020 Dec;48(12):300060520979218 [PMID: 33322979]
  10. Fertil Steril. 2011 Jun;95(7):2171-9 [PMID: 21457959]
  11. J Vasc Interv Radiol. 2003 Jan;14(1):69-74 [PMID: 12525588]
  12. Ther Adv Reprod Health. 2020 Oct 08;14:2633494120954248 [PMID: 33103116]
  13. Best Pract Res Clin Obstet Gynaecol. 2003 Apr;17(2):187-209 [PMID: 12758095]
  14. Womens Health (Lond). 2010 Jul;6(4):531-48, quiz 548-9 [PMID: 20597618]
  15. Radiology. 1987 May;163(2):511-4 [PMID: 3562835]
  16. Semin Intervent Radiol. 2008 Dec;25(4):425-31 [PMID: 21326584]
  17. Fertil Steril. 2013 Apr;99(5):1324-1331.e1 [PMID: 23290741]
  18. J Pathog. 2016;2016:4698314 [PMID: 27047692]
  19. Hum Reprod. 1992 Nov;7(10):1425-8 [PMID: 1291570]
  20. AJR Am J Roentgenol. 2000 Nov;175(5):1273-8 [PMID: 11044021]
  21. Tech Vasc Interv Radiol. 2021 Mar;24(1):100736 [PMID: 34147190]
  22. Clin Imaging. 2021 Aug;76:70-73 [PMID: 33578132]
  23. Obstet Gynecol Clin North Am. 2012 Dec;39(4):551-66 [PMID: 23182560]
  24. JAMA. 2021 Jul 06;326(1):65-76 [PMID: 34228062]
  25. Curr Probl Diagn Radiol. 2009 Sep-Oct;38(5):199-205 [PMID: 19632497]
  26. Radiographics. 2021 Oct;41(6):1876-18961 [PMID: 34597232]
  27. Radiographics. 1995 May;15(3):501-14; discussion 515-6 [PMID: 7624559]
  28. J Clin Med. 2018 May 10;7(5): [PMID: 29748467]
  29. Radiology. 1991 Jul;180(1):121-2 [PMID: 2052677]
  30. Radiographics. 2000 Nov-Dec;20(6):1759-68 [PMID: 11112827]

Word Cloud

Created with Highcharts 10.0.0tubalpatientsfallopianFTRproximaltubecanInfertilitycasesobstructionFTOrecanalizationpregnancyoccurcontrastmediamayinfertilityaffectsapproximately15%worldwide40%attributeddisease25%Evaluationpatencyperformedvialaparoscopicchromopertubationhysterosalpingographyhysterosalpingo-contrast-sonographyHyCoSyresult100%technicalsuccessraterates12851%pregnanciesoil-solubleusedversuswater-solubleComplicationsrareincludeperforationectopicpelvicinfectionReocclusiontubes2050%howeverrepeatedOverallunderutilizedtreatmentsecondaryobviatecostlytime-consumingassistivereproductivetechniquesvitrofertilizationwelldecreasingphysicalemotionalstressRecanalizationProximalFallopianTubeObstructionTreatmentocclusioninterventionalradiologywomen'shealth

Similar Articles

Cited By