Management of Proximal Tubal Occlusion
Proximal tubal occlusion (PTO) accounts for approximately 10–20% of tubal infertility cases. Diagnosis of this pathology is mainly done by HSG (Hystero Salpingo Graphy) or Sonohysterography as part of infertility investigation. Most patients with this pathology are referred for In Vitro Fertilization (IVF) program while simple surgical minimal invasive methods to treat this pathology are available. Several methods have been described in the past for the treatment of this pathology, among them trans tubal catheterization, hysteroscopy-laparoscopic guided tubal catheterization and recently hysteroscopically guided transvaginal ultrasound tubal catheterization. In all methods, spontaneous pregnancy rates can reach 40%.
Since the later method described in details in this chapter is a minimal invasive office procedure that can be carried out in the gynecologist office, it should be considered in some cases as an alternative to IVF treatments in cases of PTO.
KeywordsProximal tubal occlusion Tubal infertility Hysteroscopic tubal catheterization Transvaginal ultrasound Office procedure
Hysteroscopically guided TVUS TC (MPG 31128 kb)
- 8.Allahbadia GN, Merchant R. Fallopian tube recanalization: lessons learnt and future challenges. Womens Health. 2010;6(4):531–49.Google Scholar
- 22.Falcone T, Goldberg JM. Hysteroscopic tubal cannulation. Nezhat’s Viseo-assisted and robotic-assisted laparoscopy and hysteroscpy, vol. 75. 4th ed. Cambridge: Cambridge University Press; 2013. p. 110–3.Google Scholar