Alternative Treatment for Infertile Patients with Proximal Tubal Obstruction

Introduction Proximal tubal obstruction accounts for 10-25% of tubal infertility. In the past reconstructive microsurgery was the only treatment option. Currently, tubal cannulation under hysteroscopic or radiologic control is performed both to confirm the diagnosis and recanalize the obstructed tubes. In this report, we present our preliminary experiences with hysteroscopic tubal recanalization of proximal tubal obstruction. Method Hysteroscopic tubal cannulation was performed in 11 infertile women with proximal tubal obstruction, as diagnosed by laparoscopic chromopertubation. Successful cannulation and pregnancy rates were analysed. Results The average age and duration of infertility was 31.2±3.4 and 4.1±2.0 years, respectively. The success rate of tubal cannulation was 66.7% of tubes (12/18) and 72.7% of patients (8/11). There was no immediate complication. The pregnancy rate was 27.3% per attempted patient. No ectopic pregnancy was observed. Conclusion Hysteroscopic tubal cannulation was a safe and simple procedure. It had no radiation risk and was well-tolerated by the patients. The procedure should be offered as a first-line therapy for patients with proximal tubal obstruction and otherwise normal tubal appearance. Chiang Mai Med Bull 2006;45(3):113-118.