Factors Affecting Pregnancy Rate Following Fallopian Tube Recanalization in Women with Proximal Fallopian Tube Obstruction

Abstract

Fallopian tube obstruction is a major cause of female infertility. We aimed to evaluate the factors potentially affecting pregnancy rate following fallopian tube recanalization (FTR) in infertile women with proximal fallopian tube obstruction. Data was retrospectively collected for 61 women (25, primary infertility; 36, secondary infertility) who underwent FTR at our institution. Bivariable and multivariable analyses of clinical pregnancy rates in relation to the following factors were performed: primary vs. secondary infertility, duration of infertility, age at the time of FTR, unilateral vs. bilateral obstruction, and previous pelvic interventions. All women who underwent fluoroscopically guided transcervical FTR of one or both proximally obstructed tubes were successfully recanalized (technical success rate, 100%). Within a year after FTR, 41% of women had conceived. None of the studied variables was significantly associated with pregnancy rate on bivariable analysis. Nevertheless, on multivariable analysis, the type and duration of infertility were significantly associated with pregnancy among women aged <35 years at the time of FTR. Our findings regarding pregnancy rates following FTR reflect the diversity of the patient population and suggest the presence of multiple contributing factors. Younger women with secondary infertility for <5 years are highly likely to achieve conception following FTR.

Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo-contrast-sonography

“…Regression analysis showed that short duration of infertility (less than 2 years) was significantly associated with spontaneous conception after 4D-HyCoSy, which was consistent with published studies [4]. The reason might be that long-term tubal obstruction caused by chronic inflammatory reaction damaged the internal structures including the cilia, and made it difficult to achieve spontaneous conception [21]. Therefore, we strongly recommend that infertile women should undergo 4D-HyCoSy examination as early as possible.…”

Conception rates after fluoroscopy-guided fallopian tubal cannulation: an alternative toin vitrofertilization for patients with tubal occlusion

“…Some of these factors include the age of the patient, prior gynecology intervention, primary versus secondary infertility, and etiologies of infertility other than tubal factors. 10 In this study, secondary infertility cases appear to demonstrate higher spontaneous conception rates compared with those with primary infertility. This finding is explained by the notion that women who have had pregnancies in the past tend to have a higher incidence of fallopian tube occlusion and tend to have a higher chance of pregnancy once the underlying cause of infertility is addressed compared with their primary infertility counterparts.…”

“…The clinical data set is comparable to sample sizes in previous studies. 3 – 8 , 10 – 12 Furthermore, reporting of clinical outcomes of FTR across studies appears to be variable in that there are a staggering array of numerators and denominators used in the calculation of pregnancy rates. This may create variability in approaches to data analysis.…”

Fallopian Tube Recanalization (F.T.R): application of Interventional Radiology (I.R) post hysterosalpingography in management of female infertility at rural hospital

“…With proper techniques the average success rate post FTR alone rises up to approximately 30-35% and when utilized in combination to ARTs, significant surge in successful achieved conception or fertility are observed in state of art centers. 18,19 The complications following FTR are usually minor and major complications are very rare. The complications which may be seen in the patients undergoing FTR may include vascular contrast opacification due to forceful contrast injection or tight fibrotic blocks, fallopian tube perforation with no clinical manifestation, uterine or cervical mucosal erosion or injury and rarely uterine perforation.…”