title: Hysteroscopically guided transvaginal ultrasound tubal catheterization-a novel office procedure.
abstract: OBJECTIVE
  Investigate a novel office hysteroscopic tubal catheterization therapeutic method for proximal tubal occlusion.
  
  
  METHODS
  Prospective cohort study in a tertiary referral center. We evaluated the procedure on a group of 27 patients that were referred to our unit for proximal tubal occlusion demonstrated by hysterosalpingography, 9 (33.3%) of them with primary infertility and 18 of them (66.6%) with secondary infertility. The intervention included the usage of the modified Novy cornual cannulation set which was inserted through a 5F working cannel during an office operative hysteroscopy, followed by fallopian tube irrigation with saline-air mixture under ultrasonographic imaging.
  
  
  RESULTS
  Our series revealed no complication during or after the procedure; anesthesia was not required. One patient lost from follow-up. Of the remaining 26, 10 patients (38.4%) conceived either spontaneously or with treatment by clomiphene or gonadotropine associated with intrauterine insemination. The median time to conception was 5 months (range 4-17).
  
  
  CONCLUSIONS
  We therefore concluded that office hysteroscopic tubal catheterization is a simple (without anesthesia required) option for the treatment of patients suffering from proximal tubal occlusion. Fertility outcomes in our series are comparable to other treatments options for tubal catheterization. Therefore, tubal catheterization should not delay the assisted reproducted techniques if indicated but we propose to include it in a global integrated approach.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel. Electronic address: shlomo.cohen@sheba.health.gov.il.
authors.forename: Shlomo B
authors.initials: SB
authors.lastname: Cohen
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel.
authors.forename: Jerome
authors.initials: J
authors.lastname: Bouaziz
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel.
authors.forename: Ariella
authors.initials: A
authors.lastname: Jakobson-Setton
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel.
authors.forename: Motti
authors.initials: M
authors.lastname: Goldenberg
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Schiff
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel.
authors.forename: Raoul
authors.initials: R
authors.lastname: Orvieto
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel; IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel(2).
authors.forename: Adrian
authors.initials: A
authors.lastname: Shulman
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods*; D005184:Fallopian Tube Diseases / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods
keywords: Hysteroscopic tubal catheterization; Office procedure; Proximal tubal occlusion; Ultrasound