Wang Jeffrey W, Rustia Gabriella M, Wood-Molo Mary, Tasse Jordan, Tabriz David, Turba Ulku C, Arslan Bulent, Madassery Sreekumar
Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL, USA.
Department of Infertility and Reproductive Endocrinology, Rush University Medical Center, Chicago, IL, USA.
Ther Adv Reprod Health. 2020 Oct 8;14:2633494120954248. doi: 10.1177/2633494120954248. eCollection 2020 Jan-Dec.
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.
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 tests for continuous data or with Pearson chi-square tests for categorical data.
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).
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.
既往研究显示输卵管再通术具有良好的技术成功率。关于介入放射科医生目前在输卵管再通手术中使用的先进技术的文献稀缺。本研究调查了干预程度和输卵管通畅情况及其与技术成功率和相关妊娠结局的关联。
我们回顾性评估了在24年期间于单一中心进行的输卵管再通手术。共纳入160对接受基本不孕症评估的夫妇。进行了高压造影剂注射后的子宫输卵管造影，随后进行选择性造影、输卵管开口处的导丝导管插入术和/或微导管/微导丝再通术。通过连续数据检验或分类数据的Pearson卡方检验对相关特征的输卵管受精率进行比较，以检验统计学意义。
技术成功率为94%（341条输卵管中的319条）。单独高压造影剂注射（341条中的184条，54%）、选择性导管插入术（40%）和微导管/微导丝（6%）干预的技术成功率分别为98%、90%和73%。总体受孕率为35%（48例中的17例）。
对于因近端输卵管阻塞而寻求不孕症治疗的患者，目前的输卵管再通技术提供了一种理想且安全的选择，技术成功率高。
