Hormonal treatment of bilateral proximal tubal obstruction.
OBJECTIVE
To see whether medical suppressive treatment might be considered in the treatment of a subgroup of patients. with proximal tubal obstruction (PTO), one of the major causes for infertility, often due to endometriosis of the tubouterine junction and therefore primarily treated by operative procedures.


METHODS
23 infertile patients with bilateral PTO were treated with hormonal suppression therapy with GnRH agonists, norethindrone acetate, or danazol for at least 3 months. The average age of the patients and duration of infertility were (mean + SD) 32.4 +/- 4.8 and 3.9 +/- 2.2, respectively. Bilateral PTO was diagnosed by both hysterosalpingography and laparoscopy.


RESULTS
Fifteen of the 23 patients (65%) were diagnosed as having pelvic endometriosis prior to treatment. Following the treatment, 16 of the 23 patients (69.6%) were shown to have have at least one patent fallopian tube, and 9 patients conceived (39.1%). No patient became pregnant in the absence of one patent tube after treatment.


CONCLUSIONS
Hormonal suppressive therapy can be an alternative treatment in patients with bilateral PTO for a period as short as 3 months before any invasive procedure.
Muneyyirci-Delale
O
O
Department of Obstetrics and Gynecology, State University of New York, Health Science Center at Brooklyn, 11203, USA.
Karacan
M
M
D000328:Adult; D003613:Danazol / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004965:Estrogen Antagonists / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D010535:Laparoscopy; D016729:Leuprolide / Q000008:administration & dosage*; D009640:Norethindrone / Q000008:administration & dosage*; D011247:Pregnancy / Q000706:statistics & numerical data*; D045167:Progesterone Congeners / Q000008:administration & dosage; D012189:Retrospective Studies
D004965:Estrogen Antagonists; D005300:Fertility Agents, Female; D045167:Progesterone Congeners; D016729:Leuprolide; D003613:Danazol; D009640:Norethindrone