Reproductive performance after selective tubal catheterization.

摘要

STUDY OBJECTIVE: To evaluate the reproductive performance of women after selective tubal catheterization. DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: University teaching hospital. PATIENTS: Ninety-eight infertile women with hysterosalpingographic findings of proximal tubal occlusion. INTERVENTION: Hysterosalpingography and selective tubal catheterization. MEASUREMENTS AND MAIN RESULTS: Repeat hysterosalpingography examination before selective tubal catheterization in 98 patients revealed bilateral tubal patency in 14 patients and patency of one of the tubes in 12 others (12.2%). True proximal tubal occlusion was encountered in 72 patients (139 tubes). Successful recanalization of both tubes was achieved in 25 patients (34.7%), and successful recanalization of at least one tube was achieved in 44 patients (61.1%). Of the 72 patients who underwent selective tubal catheterization, 23 patients conceived. The cumulative probability of conception was 28%, 59%, and 73% at 12, 18, and 24 months of follow-up, respectively. The median procedure-conception interval was 16.2 months. CONCLUSION: One-quarter of patients diagnosed with bilateral proximal tubal occlusion on hysterosalpingography do not have tubal obstruction. Among those with true occlusion, selective tubal catheterization leads to an overall pregnancy rate of 31.9%.