title: Long-term reproductive outcome after hysteroscopic proximal tubal cannulation--an outcome analysis.
abstract: BACKGROUND
  The optimal therapeutic method for proximal tubal obstruction (PTO) has yet to be defined. In addition, the reported successful recanalisation rate and reproductive outcome from hysteroscopic proximal tubal cannulation have been inconsistent.
  
  
  OBJECTIVE
  To examine the morbidity and efficacy of laparoscopic-hysteroscopic proximal tubal cannulation for treating PTO.
  
  
  METHODS
  This was a retrospective study evaluating 70 infertile women with PTO who underwent laparoscopic-hysteroscopic proximal tubal cannulation in The Prince of Wales Hospital, a university-affiliated hospital, from January 2005 to December 2010. Demographical data and operative details were reviewed. Women were then contacted by phone and completed a structured questionnaire. Recanalisation rate, intra-operative complication, pregnancy rates and pregnancy outcomes were examined.
  
  
  RESULTS
  Fifty women had successful proximal cannulation on at least one side of the tube, providing an overall successful recanalisation rate of 71.4% per woman and 67.0% per tube. The overall pregnancy rate after successful hysteroscopic proximal cannulation of at least one tube is 55%. The overall mean time to become pregnant from natural conception or via clomiphene induction after successful unilateral or bilateral hysteroscopic cannulation was 10.5 ± 8.9 months. The procedure is associated with minimal morbidity. No prognostic factors were significantly associated with recanalisation and pregnancy rate.
  
  
  CONCLUSIONS
  Laparoscopic-hysteroscopic cannulation for proximal obstruction is a procedure with minimal morbidity and a reasonable successful recanalisation rate. It should be considered as an alternative to in vitro fertilisation.
authors.affiliation: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China. jacquelinechung@cuhk.edu.hk
authors.forename: Jacqueline P W
authors.initials: JP
authors.lastname: Chung
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Haines
authors.forename: Grace W S
authors.initials: GW
authors.lastname: Kong
mesh_terms: D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D016009:Chi-Square Distribution; D005184:Fallopian Tube Diseases / Q000150:complications / Q000628:therapy*; D005186:Fallopian Tube Patency Tests; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D010535:Laparoscopy / Q000009:adverse effects; D016015:Logistic Models; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013997:Time Factors