Tubal patency during the menstrual cycle and during treatment with hormonal contraceptives: a pilot study in women

Jensen, Jeffrey T.; Patil, Eva; Seguin, Jacqueline; Thurmond, Amy S.

doi:10.1177/0284185116679457

Cited by 3 publications

(3 citation statements)

References 14 publications

(16 reference statements)

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“…One subject showed bilateral FO during the follicular phase examination (E 2 = 36 pg/mL), but BTP in the luteal phase (E 2 = 52 pg/mL), COC cycle, and DMPA examinations. Two subjects had functional occlusion during the COC cycle, and one following treatment with DMPA . These results suggest that our findings in the baboon apply to human medicine.…”

Section: Discussionsupporting

confidence: 62%

Effect of menstrual cycle phase and hormonal treatments on evaluation of tubal patency in baboons

Jensen

Hanna

Mishler

et al. 2017

J of Medical Primatology

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Background We evaluated whether menstrual cycle phase influences the assessment of tubal patency by hysterosalpingography (HSG) in baboons. Methods Retrospective analysis of baseline tubal patency studies and serum estradiol (E2) and progesterone (P4) values obtained from female baboons used as models for development of nonsurgical permanent contraception in women. The main outcome measure was bilateral tubal patency (BTP) in relationship to estradiol level. Results Female baboons (n =110) underwent a single (n= 81), two (n=26), or three (n=3) HSG exams. In 33/142 (23%) HSG exams, one or both tubes showed functional occlusion (FO). The median E2 in studies with BTP (49 pg/mL) was significantly higher than in those studies with FO (32 pg/mL, p = .005). Among 18 animals with repeat exams where serum E2 changed from <60 to ≥ 60 pg/mL, 13 results changed from FO to BTP (p=.0001). No sets showed a change from BTP to FO with an increase in estradiol. Conclusion In baboons, functional occlusion of the fallopian tube is associated with low estradiol levels, supporting a role for estrogen-mediated relaxation of the utero-tubal junction.

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Section: Discussionsupporting

confidence: 62%

Effect of menstrual cycle phase and hormonal treatments on evaluation of tubal patency in baboons

Jensen

Hanna

Mishler

et al. 2017

J of Medical Primatology

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“…25 In a pilot study, repeated hysterosalpingography (HSG) was used to confirm functional proximal FT occlusion in women using depot MPA. 26 Repeated HSG pain, irradiation, and invasiveness, in addition to ethical controversies, are the significant disadvantages of this study. For the past decade, our institution has been interested in study of the FT function utilizing hysteroscopy.…”

Section: Discussionmentioning

confidence: 97%

Hysteroscopic evaluation of endometrial changes and fallopian tubal functions in women using progestin-only contraceptives

Darwish,

Mohammad,

Gendy

et al. 2024

J Med Life Sci

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The purpose of this prospective study was to investigate whether office hysteroscopy (OH) can be used to assess the mechanisms of action of progestogen-only contraceptives (POCs), diagnose possible local causes of abnormal uterine bleeding (AUB), and support the treatment plan of symptomatic patients using POCs compared with those who do not use hormones. The study included 140 women who were divided into two groups. Group A consisted of 70 women who used POCs, whereas group B consisted of 70 women who did not use hormones. They were successively examined using transvaginal ultrasonography (TVS), OH, and endometrial sampling. The TVS results were consistent with those of OH and histopathology. The changes in endometrial thickness and vasculature, as well as fallopian tube (FT) functions, were significantly more pronounced in POC users than in non-POC users. There was a significant reduction in the peristalsis of the proximal part of the FT, as well as a reduction in the bubble flow test in group A compared with group B. In addition, the combination of peristalsis and the bubble flow test (Darwishscope test) was significantly lower in group A. It was concluded that using OH as a simple diagnostic tool in women with POCs would contribute to a better understanding of the mechanisms of endometrial and FT effects and explain some local endometrial causes of AUB. This ensures that the combination of TVS and OH would limit routine endometrial sampling in POCs users.

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“…The study coordinator measured vital signs including height and weight. Given that functional tubal patency may fluctuate with the menstrual cycle, participants provided a serum sample for hormonal analysis to confirm cycle stage [9]. One non-blinded boardcertified radiologist who specializes in women's imaging conducted all study procedures.…”

Section: Methodsmentioning

confidence: 99%

Intrauterine fluid instillation to confirm tubal occlusion after transcervical permanent contraception: A pilot study,

et al. 2020

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Objectives: To determine if women with tubal patency experience more fluid loss compared to those with bilateral tubal occlusion following intrauterine instillation of fluid via a balloon catheter. Study Design:In this prospective cohort pilot study, we enrolled women with prior Essure ® procedures and healthy controls from September 2016-July 2017. We excluded women using an implant or intrauterine device, or with a prior cesarean delivery or permanent contraception procedures other than Essure ® . An infusion pump delivered saline via balloon catheter under continuous pressure monitoring. After one minute, we withdrew the fluid and recorded volumes in and out. Subjects then underwent hysterosalpingogram for evaluation of tubal patency. We conducted crude analyses with t-tests and sensitivity analyses.Results: We recruited 23 participants; ten provided analyzable data in each group. Hysterosalpingogram confirmed patency in all control and occlusion in all post-Essure ® subjects in the analysis group. We found the median volume of saline lost among control subjects [7.8 mL (7.4, 8.4)] larger than post-Essure ® participants [2.2 mL (2.0, 3.8), p<0.01]. While 50% of control subjects tolerated the full 10mL of fluid instillation, none of the post-Essure ® subjects tolerated this volume (p=0.03). A combination of saline loss ≤4mL and participant intolerance of the full 10mL volume yielded sensitivity of 0.80 (95%CI: 0.57, 1.00) and specificity of 1.00 for bilateral tubal occlusion. Conclusion:Instillation of a fixed volume into the uterus may discriminate between women with tubal patency and occlusion following permanent contraception procedures with high specificity

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Tubal patency during the menstrual cycle and during treatment with hormonal contraceptives: a pilot study in women

Cited by 3 publications

References 14 publications

Effect of menstrual cycle phase and hormonal treatments on evaluation of tubal patency in baboons

Effect of menstrual cycle phase and hormonal treatments on evaluation of tubal patency in baboons

Hysteroscopic evaluation of endometrial changes and fallopian tubal functions in women using progestin-only contraceptives

Intrauterine fluid instillation to confirm tubal occlusion after transcervical permanent contraception: A pilot study,

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