Factors affecting the success of fallopian tube recanalization in treatment of tubal obstructive infertility

Shen, Huawei; Cai, Mingjin; Chen, Ting-Wei; Zheng, Duzhou; Huang, Shikuan; Zhou, Mimi; He, Wei; Li, Yongsen; Tan, Qianyan

doi:10.1177/0300060520979218

Cited by 12 publications

(16 citation statements)

References 27 publications

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“…Some studies have shown that women with secondary infertility have a higher likelihood of having tubal occlusion, at least on hysterosalpingography, compared to those with primary infertility, with an adjusted risk ratio of 1.75 [19]. These findings are more often related to surgical causes than in woman with primary infertility, who, in contrast, show higher rates of congenital causes of tubal occlusion [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

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

Mayrhofer

Parry

Hager

et al. 2022

JCM

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Endometriosis seems to have a strong negative effect on female fertility. The aim of this study was to assess the rate of tubal occlusion diagnosed via laparoscopic chromopertubation in infertile women with endometriosis and compare the results to infertile women without endometriosis. In this retrospective cohort study, 275 infertile women with endometriosis and 49 infertile women without endometriosis undergoing diagnostic laparoscopy for primary or secondary infertility with chromopertubation at the Medical University of Vienna between January 2012 and December 2020 have been investigated. During the laparoscopic assessment of tubal patency, significantly more fallopian tubes were occluded in the endometriosis group compared to the control group (25.8 versus 15.3%; p = 0.029). Unilateral and bilateral occlusion was found significantly more often in patients with endometriosis (p = 0.021). In the multivariate analysis, only the rASRM stage (the revised classification of endometriosis by the American Society for Reproductive Medicine) showed a significant association with bilateral occlusion (OR 1.400, 95%CI: 1.018–1.926; p = 0.038). Both a higher rASRM stage (OR 2.181, 95%CI: 1.191–3.995; p = 0.012) and secondary infertility (OR 1.514, 95%CI: 1.156–1.983; p = 0.003) were associated with an increased risk for any kind of fallopian tube occlusion. Endometriosis seems to be associated with an increased risk for fallopian tube occlusion. The rate of tubal occlusion increased significantly with the rASRM stage.

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Section: Discussionmentioning

confidence: 99%

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

Mayrhofer

Parry

Hager

et al. 2022

JCM

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“…Tubal obstruction is one of the most common causes of female infertility, accounting for approximately 14%–45% of all female infertilities ( Hanson et al, 2017 ; Shen et al, 2020 ). The recanalization rate of traditional tubal interventional procedures is approximately 90% ( Knuttinen et al, 2014 ; Ikechebelu et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“…The recanalization rate of traditional tubal interventional procedures is approximately 90% ( Knuttinen et al, 2014 ; Ikechebelu et al, 2018 ). But a high post-injection re-occlusion rate of 20–50% ( Knuttinen et al, 2014 ) has been seen, as well as a low pregnancy rate of about 30% ( Ikechebelu et al, 2018 ; Huang et al, 2019 ; Shen et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…The Inclusion criteria were 1) females of childbearing age (between 22 and 45 years), and 2) a Fallopian tube isthmus or interstitial obstruction diagnosed without adhesions of the fimbriated tubal extremity, determined on laparoscopic examination or salpingography. The exclusion criteria were 1) pelvic infection, congenital physiological defects or malformations, infertility caused by genetic factors, endocrine factors [follicle-stimulating hormone (FSH) or luteinizing hormone [LH] or other hormones] or immune factors, 2) endometriosis, uterine myoma, uterine hypoplasia, tubal ligation, or pelvic tuberculosis, 3) male partners were diagnosed with reproductive dysfunction ( Huang et al, 2019 ; Shen et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

“…FTR had become the universally accepted therapeutic option of fallopian tube obstruction in the last 2 decades ( Verma et al, 2009 ; Anil et al, 2011 ). However, more than 20% of patients have poor outcomes following interventional recanalization ( Shen et al, 2020 ). Niuniu Sun showed that fallopian tube recanalization by ozone perfusion could effectively increase the postoperative pregnancy rate, but there was no significant difference in the recanalization success rate by ozone perfusion ( Sun et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Dose-Effect Relationship of Chitosan and Danshen Combined Injection for Fallopian Tube Recanalization

Huang

Liang

et al. 2022

Front. Pharmacol.

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Objectives: This study examined the dose-effect relationship of chitosan and danshen combined injections on the long-term prevention of fallopian tube re-obstructions, with increased pregnancy rates in infertile women.Methods: High-performance liquid chromatography was used to determine the content changes of combined chitosan and danshen injection. Two hundred and eighty patients with fallopian tube obstructions were randomly assigned to four groups. Group A (control group, saline), Group B (2 ml chitosan, 4 ml danshen), Group C (2 ml chitosan, 10 ml danshen), and Group D (1 ml chitosan, 10 ml danshen). Injections were administered after tubal recanalization.Results: The effective constituent of chitosan and danshen injection was stable. Tubal patency rate was 94.2% and 87.3% in Group C after 1 and 3 years, respectively, which was significantly higher than Groups A (38.6%, 31.5%), B (73.5%, 64.1%), and D (68.5%, 50.7%). Intrauterine pregnancy rates were 61.8% and 79.4% in Group C after 1 and 3 years, respectively, and were significantly higher than Groups A (31.8%, 34.8%), B (40.1%, 62.5%), and D (38.5%, 58.5%) (p < 0.05).Conclusion: Combined Chitosan and danshen injections prevented tubal obstruction and increased pregnancy rates for long periods using an optimal ratio of 1 part chitosan and 5 parts danshen.

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High level of thyroid peroxidase antibodies as a detrimental risk of pregnancy outcomes in euthyroid women undergoing ART: A meta‐analysis

Zhang

Yang

et al. 2023

Molecular Reproduction Devel

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Thyroid autoimmunity (TAI) triggered by genetic and epigenetic variation occurs mostly in women of reproductive age. TAI is described mainly by positivity of anti‐thyroid peroxidase antibody (TPO‐Ab) and/or thyroglobulin antibody (TG‐Ab). TPO‐Ab, but not TG‐Ab, was suggested to be associated with pregnancy outcome in euthyroid women undergoing assisted reproductive technology (ART), but their results are conflicting. This meta‐analysis was performed to decide whether the presence of TPO‐Ab—in a concentration dependent manner—correlates with the success of ART. A systematic literature search was performed in the PubMed, Web of Science, and EMBASE databases for relevant articles published from January 1999 to April 2022, and these studies focused on the effect of TAI on pregnancy outcomes of women who underwent in vitro fertilization, intracytoplasmic sperm injection and intrauterine insemination and met the inclusion criteria: (i) the studies were prospective or retrospective study; (ii) all patients undergoing ART were tested for thyroid‐related antibodies; (iii) the assessed ART outcomes included miscarriage rate (MR) or delivery rate (DR). The exclusion criteria were: (i) female congenital uterine malformation, chromosomal diseases and other infectious diseases; (ii) overt hypothyroidism or pre‐existing thyroid disease; (iii) thrombus tendency. We divided the included patients into three groups according to the TPO‐Ab threshold they defined: (i) TPO‐Ab (−), threshold <34 IU/mL; (ii) TPO‐Ab‐34, threshold >34 IU/mL; (iii) TPO‐Ab‐100, threshold >100 IU/mL. We then extracted necessary relevant data, including MR and DR. Egger's test was used to evaluate the risk of publication bias. This meta‐analysis included a total of 7 literatures involving 7466 patients with TAI (−) and 965 patients with TAI (+) and revealed that there was no significant difference between group TPO‐Ab‐34 and group TPO‐Ab (−) in MR [risk ratio (RR): 0.61 (0.35, 1.08), p = 0.09] and DR [RR: 0.97 (0.83, 1.13), p = 0.69]. By contrast, compared to TPO‐Ab (−) group, TPO‐Ab‐100 patients showed markedly higher MR [RR: 2.12 (1.52, 2.96), p = 0.0046], and lower DR [RR: 0.66 (0.49, 0.88), p < 0.0001] with high degree of statistical significance. This meta‐analysis suggests that, for euthyroid patients, high level of TPO‐Ab (>100 IU/mL) could adversely influence the pregnancy outcome of ART.

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Factors affecting the success of fallopian tube recanalization in treatment of tubal obstructive infertility

Cited by 12 publications

References 27 publications

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

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

Dose-Effect Relationship of Chitosan and Danshen Combined Injection for Fallopian Tube Recanalization

High level of thyroid peroxidase antibodies as a detrimental risk of pregnancy outcomes in euthyroid women undergoing ART: A meta‐analysis

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