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Muacevic A, Adler JR. A Review of Tubal Factors Affecting Fertility and its Management. Cureus 2022; 14:e30990. [PMID: 36475176 PMCID: PMC9717713 DOI: 10.7759/cureus.30990] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/01/2022] [Indexed: 01/25/2023] Open
Abstract
Infertility is a problem that affects both developed and developing countries today. Many couples choose to have financial stability before conception, irrespective of age. Tubal blockage accounts for 30%-40% of a woman's fertility. Congenital abnormalities, acute and persistent inflammatory diseases, endometriosis, and different pathologies are associated with infertility and cause partial or complete obstruction of the fallopian tubes. Approximately 30% of women experience infertility due to fallopian tube illness, with 10%-25% of these women experiencing proximal fallopian tube obstruction. The fallopian tube is an integral part of the union of sperm, and its normal function is a prerequisite for natural conception. Tubal obstruction is a common cause of infertility. These patients are keen to unblock their blocked fallopian tubes and restore reproductive function. Accurate diagnosis and optimal treatment options are essential for treating infertility.
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Wang JW, Rustia GM, Wood-Molo M, Tasse J, Tabriz D, Turba UC, Arslan B, Madassery S. Conception rates after fluoroscopy-guided fallopian tubal cannulation: an alternative to in vitro fertilization for patients with tubal occlusion. Ther Adv Reprod Health 2020; 14:2633494120954248. [PMID: 33103116 PMCID: PMC7549323 DOI: 10.1177/2633494120954248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 08/06/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: Previous studies show good technical success rates for fallopian tube
recanalization. Scarce literature exists regarding advance techniques
currently used by interventional radiologists during fallopian tube
recanalization procedures. This study investigates the level of intervention
and tubal patency and its association with technical success and associated
pregnancy outcomes. Methods: We retrospectively evaluated fallopian tube recanalization procedures
performed at a single center in a 24-year period. A total of 160 couples
undergoing a basic infertility evaluation were included.
Hysterosalpingography with high pressure contrast injection followed by
selective contrast, guidewire catheterization at the tubal ostium, and/or
microcatheter/microwire recanalization were performed. Comparisons of the
tubal fertilization rate by relevant characteristics were tested for
statistical significance with t tests for continuous data
or with Pearson chi-square tests for categorical data. Results: Technical success rate was 94% (319 of 341 tubes). High pressure contrast
injection alone (184 of 341, 54%), selective catheterization (40%), and
microcatheter/microwire (6%) interventions yielded technical success rates
of 98%, 90%, and 73%, respectively. The overall rate of conception was 35%
(17 of 48). Conclusion: Current techniques of fallopian tube recanalization offer a desirable and
safe option with high technical success for patients seeking treatment for
infertility due to proximal fallopian tube obstruction.
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Affiliation(s)
- Jeffrey W Wang
- Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL, USA
| | - Gabriella M Rustia
- Department of Infertility and Reproductive Endocrinology, Rush University Medical Center, Chicago, IL, USA
| | - Mary Wood-Molo
- Department of Infertility and Reproductive Endocrinology, Rush University Medical Center, Chicago, IL, USA
| | - Jordan Tasse
- Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL, USA
| | - David Tabriz
- Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL, USA
| | - Ulku C Turba
- Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL, USA
| | - Bulent Arslan
- Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL, USA
| | - Sreekumar Madassery
- Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA
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Huang C, He X, Luo W, Chen H, Huang Y. Combined chitosan and Dan-shen injection for long-term tubal patency in fallopian tube recanalization for infertility. Drug Deliv Transl Res 2020; 9:738-747. [PMID: 30610502 PMCID: PMC6606764 DOI: 10.1007/s13346-018-00611-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To prospectively study the efficacy of different anti-adhesion agents for the prevention of tubal obstruction after recanalization, this trial was approved by our hospital ethics committee. Four hundred patients with fallopian tube obstruction were randomly assigned to four groups. The control group underwent recanalization alone, whereas the other groups were injected with chitosan, Dan-shen, or combined chitosan and Dan-shen after recanalization. The tubal patency rate in all four groups was recorded after 12 day, 3 months, and 12 months. The pregnancy rates were noted after 12 months. The recanalization rates after 1 day in the control, chitosan, Dan-shen, and combined chitosan and Dan-shen groups were 94.1, 97.1, 96.5, and 98.2%, respectively (p = 0.18, p > 0.05). The rates of tubal patency after 3 months were significantly higher in the combined chitosan and Dan-shen (96.5%), chitosan (88%), and Dan-shen (85.2%) groups compared with the control group (73.9%) (p = 0.0001, p < 0.05). The recanalization rate and intrauterine pregnancy rate after 12 months was significantly higher in the combined chitosan and Dan-shen group (93.8 and 63.9%, respectively) compared with the other groups (control 39 and 30.6%, chitosan 78.4 and 46.9%, and Dan-shen 77.3 and 43.3%) (p = 0.0029 and p = 0.0001, p < 0.05). Chitosan, Dan-shen, or a combination of the two compounds could be effective for preventing tubal obstruction after interventional recanalization, possibly increasing the rate of pregnancy in affected women. The combined chitosan and Dan-shen injection has unique advantages in the interventional recanalization of obstructed fallopian tubes.
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Affiliation(s)
- Chen Huang
- Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, 511400 China
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
- Medical Imaging Institute of Panyu, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Xueping He
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Wenfeng Luo
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
- Medical Imaging Institute of Panyu, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Hanwei Chen
- Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, 511400 China
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
- Medical Imaging Institute of Panyu, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Yi Huang
- Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, 511400 China
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
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Factors Affecting Pregnancy Rate Following Fallopian Tube Recanalization in Women with Proximal Fallopian Tube Obstruction. J Clin Med 2018; 7:jcm7050110. [PMID: 29748467 PMCID: PMC5977149 DOI: 10.3390/jcm7050110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/20/2022] Open
Abstract
Fallopian tube obstruction is a major cause of female infertility. We aimed to evaluate the factors potentially affecting pregnancy rate following fallopian tube recanalization (FTR) in infertile women with proximal fallopian tube obstruction. Data was retrospectively collected for 61 women (25, primary infertility; 36, secondary infertility) who underwent FTR at our institution. Bivariable and multivariable analyses of clinical pregnancy rates in relation to the following factors were performed: primary vs. secondary infertility, duration of infertility, age at the time of FTR, unilateral vs. bilateral obstruction, and previous pelvic interventions. All women who underwent fluoroscopically guided transcervical FTR of one or both proximally obstructed tubes were successfully recanalized (technical success rate, 100%). Within a year after FTR, 41% of women had conceived. None of the studied variables was significantly associated with pregnancy rate on bivariable analysis. Nevertheless, on multivariable analysis, the type and duration of infertility were significantly associated with pregnancy among women aged <35 years at the time of FTR. Our findings regarding pregnancy rates following FTR reflect the diversity of the patient population and suggest the presence of multiple contributing factors. Younger women with secondary infertility for <5 years are highly likely to achieve conception following FTR.
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