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Ultrasonography-guided hysteroscopic tubal catheterization of proximally occluded tubes - reproductive outcomes |
S. B. Cohen1, M. Shapira1, *( ), A. Baron1, J. Bouaziz1, R. Mashiach1, M. Goldenberg1, R. Orvieto1 |
1Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel - Aviv University, Tel-Hashomer, Israel |
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Abstract Objective: To evaluate the reproductive outcomes of infertile patients suffering from proximal tubal occlusion (PTO) following ultrasonography-guided hysteroscopic tubal catheterization (HTC). Materials and Methods: A retrospective cohort study of infertile patients who underwent ultrasonography-guided HTC in a tertiary hospital, between 2010 and 2016. All patients included were diagnosed with unilateral/bilateral PTO on hysterosalpingograpy (HSG). HTC was performed using a 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. Patients who did not conceive in the following 6-12 months were referred to IVF treatment. Results: Sixty-one patients were included. Tubal recanalization rate was achieved in 25/25 of unilaterally occluded tubes (100%), and in 63/72 of bilaterally occluded tubes (87.5%). Median duration of follow up after catheterization was 40.57 months. In a median of 3.5 months following the procedure, 16 (26.2%) patients conceived spontaneously (n=14) or following intrauterine insemination (n=2), 12 (19.6%) of them delivered . Twenty-two additional patients underwent IVF after a median of 11 months following HTC. Sixteen of them conceived following a median of two cycles, of whom 75% failed IVF treatment prior to HTC. Conclusion: Ultrasonography-guided HTC may form an acceptable treatment modality in cases of PTO. Further research is needed to investigate the role of HTC in cases of PTO and repeated implantation failure.
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Published: 10 December 2019
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*Corresponding Author(s):
M. SHAPIRA
E-mail: shapira.moran@gmail.com
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