Semin intervent Radiol 2000; Volume 17(Number 03): 303-308
DOI: 10.1055/s-2000-9415
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Fallopian Tube Recanalization

Amy S. Thurmond
  • Legacy Park Meridian Hospital, Oregon Health Sciences University, Portland, Oregon
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Publikationsverlauf

Publikationsdatum:
31. Dezember 2000 (online)

ABSTRACT

The first hysterosalpingogram may have been peformed only 15 years after Roentgen discovered medical x-rays. It is a standard test that nonetheless figures prominently in modern decision making for more than 300,000 infertile couples in the United States alone. The application of angiographic techniques to this old-fashioned test has revolutionized the diagnosis and treatment of proximal tubal obstruction. Results from worldwide centers have shown that nonsurgical recanalization of proximally obstructed tubes can be accomplished in about 90% of patients using a variety of catheter techniques. The pregnancy rate in a population that was recommended for tubal microsurgery or in vitro fertilization because of well-documented, isolated proximal tubal obstruction, but underwent catheter tubal recanalization instead without any other therapy, was 58% by 1 year and all pregnancies were intrauterine. In a population in which the cause of infertility is less well defined and additional tubal disease may be present, one would expect a lower short-term pregnancy rate, about 30 to 40%, and about 10% ectopic pregnancies. The American Society for Reproductive Medicine (formerly the American Fertility Society) has recommended that patients who have proximal tubal obstruction undergo selective salpingography and tubal recanalization prior to the more invasive and costly treatments that were used in the past.

REFERENCES

  • 1 Sulak P J, Letterie G S, Coddington C C. Histology of proximal tubal occlusion.  Fertil Steril . 1987;  48 437-440
  • 2 Thurmond A S, Novy M, Rösch J. Terbutaline in diagnosis of interstitial fallopian tube obstruction.  Invest Radiol . 1988;  23 209-210
  • 3 Sweeney W J. The interstitial portion of the uterine tube: Its gross anatomy, course, and length.  Obstet Gynecol . 1961;  19 3-8
  • 4 Platia M P, Krudy A F. Transvaginal fluoroscopic recanalization of a proximally occluded oviduct.  Fertil Steril . 1985;  44 704-706
  • 5 Confino E, Friberg J, Gleicher N. Transcervical balloon tuboplasty.  Fertil Steril . 1986;  46 963-966
  • 6 Thurmond A S, Novy M, Uchida B T, Rösch J. Fallopian tube obstruction: Selective salpingography and recanalization.  Radiology . 1987;  174 571-572
  • 7 Jansen R PS, Anderson J C, Sutherland P D. Nonoperative embryo transfer to the fallopian tube.  N Engl J Med . 1988;  319 288-291
  • 8 DeCherney A H. Anything you can do I can do better .  . . or differently! Fertil Steril. 1987;  48 374-376
  • 9 Guideline for Tubal Disease. American Fertility Society February 15, 1993
  • 10 Thurmond A S. Selective salpingography and fallopian tube recanalization.  AJR . 1991;  156 33-38
  • 11 Novy M J, Thurmond A S, Patton P E, Uchida B T, Rösch J. Diagnosis of cornual obstruction by transcervical fallopian tube cannulation.  Fertil Steril . 1988;  50 434-440
  • 12 Thurmond A S. Pregnancies after selective salpingography and tubal recanalization.  Radiology . 1994;  190 11-13
  • 13 Thurmond A S, Burry K A, Novy M J. Salpingitis isthmic nodosa: Results of transcervical fluoroscopic catheter recanalization.  Fertil Steril . 1995;  63 715-722
  • 14 Thurmond A S, Rosch J. Nonsurgical fallopian tube recanalization for treatment of infertility.  Radiology . 1990;  174 371-374
  • 15 Jansen R PS, Anderson J C. Transvaginal versus laparoscopic gamete intrafallopian transfer: A case-controlled retrospective comparison.  Fertil Steril . 1993;  59 836-840
  • 16 Risquez F, Pennehouat G, Folot H. Transcervical tubal cannulation and falloposcopy for the management of tubal pregnancy.  Hum Reprod . 1992;  7 274-275
  • 17 Ross P L, Thurmond A S, Uchida B T, Jones M K, Scanlan R M, Kessel E. Transcatheter tubal sterilization in rabbits: Technique and results.  Invest Radiol . 1994;  29 570-573
  • 18 Maubon A J, Thurmond A S, Laurent A, Honiger J E, Scanlan R M, Rouanet J P. Selective tubal sterilization in rabbits: Experience with a hydrogel combined with a sclerosing agent.  Radiology . 1994;  193 721-723
  • 19 Thurmond A S, Uchida B T, Rosch J. Device for hysterosalpingography and fallopian tube catheterization.  Radiology . 1990;  174 571-572
  • 20 Thurmond A S, Rosch J. Fallopian tubes: Improved technique for catheterization.  Radiology . 1990;  174 572-573
  • 21 Hedgpeth (Ross) P L, Thurmond A S, Fry R. Radiographic fallopian tube recanalization: Absorbed ovarian radiation dose.  Radiology . 1991;  180 121-122
  • 22 Thurmond A S. Procedures for diagnosis and treatment in Infertility. In: Thurmond AS, Jones MK, Cohen D (eds): Gynecologic, Obstetric, and Breast Radiology: A text/atlas of Imaging in Women Cambridge, MA: Blackwell Science 1997: 114-123
  • 23 Thurmond A S, Rosch J, Patton P E. Fluoroscopic transcervical fallopian tube catheterization for diagnosis and treatment of female infertility caused by tubal obstruction.  Radiographics . 1988;  8 621-640
  • 24 Thurmond A S, Patton P E, Hector D M. US-guided fallopian tube catheterization.  Radiology . 1991;  180 571-572
  • 25 Kerin J F, Williams D B, San Roman G A, Pearlstone A C, Grundfest W S, Surrey E S. Falloposcopic classification and treatment of fallopian tube lumen disease.  Fertil Steril . 1992;  57 731-741