Successful conception following Fallopian tube recanalization in infertile patients with a unilateral proximally occluded tube and a contralateral patent tube.
BACKGROUND
There are many published case reports of successful conception following transcervical Fallopian tube recanalization (T-FTR) in patients with bilateral proximally occluded Fallopian tubes. However, no serial trials have been published with respect to successful conception following unilateral tubal recanalization in infertile patients with a unilateral proximally occluded tube and a contralateral patent tube. This study was designated to analyse the success rate of T-FTR and the pregnancy rate due to natural fertilization in the lumen of the recanalized tube in these patients.


METHODS
We have encountered only 11 patients with this abnormality in our department in the past 10 years. T-FTR with fluoroscopic guidance was performed in these patients, confirmed by at least two hysterosalpingographies to exclude tubal spasm. The uterine catheter devised by us was used during the procedure.


RESULTS
All 11 Fallopian tubes were successfully opened by T-FTR. In the six patients who conceived, a preovulatory follicle was demonstrated on the side of the cannulated tube during the conception. The success rate of recanalization, the pregnancy rate due to fertilization in the lumen of the recanalized tube and the successful delivery rate were 100, 55 and 36% respectively.


CONCLUSIONS
Our findings suggest that a functional and/or organic disorder in the patent tube resulted in infertility in patients with unilateral proximal tubal obstruction. Our results further show that recanalization of occluded tubes is an effective treatment. Thus, recognition of successful conception following T-FTR in these patients will be beneficial to our clinical approach to this infertile condition.
Hayashi
Masatoshi
M
Department of Obstetrics and Gynaecology, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50, Minami-Koshigaya, Koshigaya-shi, Saitama 343-8555, Japan. mhayashi@lilac.plala.or.jp
Hoshimoto
Kazunori
K
Ohkura
Takeyoshi
T
D000328:Adult; D001723:Birth Rate; D002404:Catheterization; D003251:Constriction, Pathologic; D005184:Fallopian Tube Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D005186:Fallopian Tube Patency Tests; D005187:Fallopian Tubes / Q000503:physiopathology*; D005260:Female; D005306:Fertilization; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000209:etiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies