Falloposcopic tuboplasty for bilateral tubal occlusion. A novel infertility treatment as an alternative for in-vitro fertilization?

Abstract

The linear everting (LE) catheter has been developed to safely guide a Falloposcope into the entire length of Fallopian tube in order to observe the tubal lumen. It may also be useful therapeutically for the recanalization of occluded tubes. Fifty infertility patients who had been diagnosed with proximal, mid and distal tubal occlusion by hysterosalpingogram, Rubin test and hysteroscopic selective hydrotubation, were selected to undergo Falloposcopic tuboplasty (FT). Patients having hydrosalpinges were excluded from the study group. The total number of tubes treated was 102 during 53 FT procedures. On the basis of tubes attempted, the LE catheter successfully accessed 85.3% (87/102). A follow-up hysterosalpingogram was completed 1-3 months following the FT procedure, which revealed an overall patency rate of 79.4% (81/102). During FT, a high incidence of multiple adhesions was observed in the entire length of tubal lumen in patients having bilateral occlusions. To date, the total number of pregnancies following FT treatment is 11 over a follow-up period of 2 months to 3 years. FT has been established as a highly useful, less invasive and novel treatment for tubal infertility. This technique may be useful in selected patients with tubal infertility.

Falloposcopic tuboplasty as an option for tubal infertility: an alternative to in vitro fertilization

“…In the 1990s, the concept of tubal cannulation emerged again as an alternative to treat patients with cornual obstruction. For this purpose, the technique of falloposcopic tuboplasty (FT) has been established as a tool to reopen occluded fallopian tubes (2,3). This is a case series of 160 tubal infertile patients who underwent FT from January 1, 2005, to February 28, 2010, at our institution.…”

Role of Falloposcopy in the Management of Subfertility

“…These obstacles could be overcome by using smaller directional guidewire, softer distension-free Teflon catheters, improved microendoscopes and improved surgical skills necessary for a safe and fruitful falloposcopy. [16][17][18][19][20] All these studies are revealing the importance and efficacy of falloposcopy in both diagnosing tubal infertility and treating it based on the pathology. However, falloposcopy has been shown to be a highly useful, minimally invasive procedure in diagnosing and treating patients with proximal, mid and distal tubal disease as a cause of their subfertility.…”

Diagnostic and remedial capability of transcervical falloposcopy in conjunction with laparoscopy

“…Alternatively, it can also be performed via falloposcopy, which permits direct visualization inspection of the inside of the fallopian tubes. The fallopian tubes are approached through the cervix and uterus [21]. It is a microendoscopic approach for directly visualizing the tubal mucosa from the ampullary-isthmic junction to the fimbria.…”