Fallopian Tube Catheterization

ABSTRACT

The delicate fallopian tube is the anatomic pathway to human reproduction. Simple, inexpensive tools and techniques allow radiologists to access this structure for promoting, and preventing pregnancy. Results from centers worldwide have shown that catheter recanalization is possible in ~90% of women with proximal tubal occlusion using basic angiographic techniques familiar to all interventional radiologists. The American Society for Reproductive Medicine has recommended that patients in whom the hysterosalpingogram (HSG) demonstrates proximal tubal occlusion undergo fallopian tube catheterization with selective salpingography prior to more invasive and more costly infertility treatments. The pregnancy rate following fallopian tube recanalization is as high as 60% when the unblocked tubes are found to be normal and there is no history of tubal disease. In a population where the cause of infertility is less well-defined, tubal catheterization may not only help women conceive, but may also help to better define the underlying tubal abnormality. In the prevention of unwanted pregnancy, numerous materials and devices have been tested for blocking fallopian tubes. The ESSURE coil (Conceptus, Inc., Mountain View, CA) was FDA approved in 2002 for tubal sterilization by hysteroscopic placement. In some locales, radiologists are being asked to assist with this procedure or to place the coils fluoroscopically through fallopian tube catheterization.

KEYWORDS

Fallopian tube - hysterosalpingography - catheterization - fertility - sterilization

REFERENCES

• 1 Woodruff JD, Pauerstein CJ The Fallopian Tube: Structure, Function, Management. Baltimore; Williams and Wilkins 1969
• 2 Sulak P J, Letterie G S, Coddington C C et al.. Histology of proximal tubal occlusion.  Fertil Steril. 1987;  48 437-440
• 3 Papaioannou S. A hypothesis for the pathogenesis and natural history of proximal tubal blockage.  Hum Reprod. 2004;  19 481-485
• 4 Smith W T. New method of treating sterility by removal of obstructions of the fallopian tubes.  Lancet. 1849;  1 529-530
• 5 Friorep R. Zur Vorbeugung der Notwendigkeit des Kaiserschnitts und der perforation.  Notiz Geburtshilfe Natur Heikunde. 1849;  221 9-10
• 6 Sweeney W J. The interstitial portion of the uterine tube: its gross anatomy, course, and length.  Obstet Gynecol. 1962;  19 3-8
• 7 Rouanet J P, Chalut J. Une application du catheterisme selectif: la salpingographie.  Nouv Presse Med. 1977;  31 2785
• 8 Platia M P, Krudy A G. Transvaginal fluoroscopic recanalization of a proximally occluded oviduct.  Fertil Steril. 1985;  44 704-706
• 9 Confino E, Friberg J, Gleicher N. Transcervical balloon tuboplasty (TBT).  Fertil Steril. 1986;  46 963-966
• 10 Jansen R PS, Anderson J C. Catheterization of the fallopian tube from the vagina.  Lancet. 1987;  2 309-310
• 11 Thurmond A S, Novy M, Uchida B T et al.. Fallopian tube obstruction: selective salpingography and recanalization. Work in Progress.  Radiology. 1987;  163 511-514
• 12 American Fertility Society .Guideline for Tubal Disease. Birmingham, AL; American Society for Reproductive Medicine (formerly American Fertility Society) 1993
• 13 Thurmond A S, Rosch J, Ross P L et al.. Transvaginal fallopian tube catheterization in an animal model.  Invest Radiol. 1988;  23 818-821
• 14 Ross P L, Thurmond A S, Jones M J et al.. Transcatheter tubal sterilization in rabbits: techniques and results.  Invest Radiol. 1994;  29 570-573
• 15 Maubon A J, Thurmond A S, Laurent A et al.. Selective tubal sterilization in rabbits: experience with a hydrogel combined with a sclerosing agent.  Radiology. 1994;  193 721-723
• 16 Schmitz-Rode T, Ross P L, Timmermans H et al.. Experimental nonsurgical female sterilization: trancervical implantation of microspindles in fallopian tubes.  J Vasc Interv Radiol. 1994;  5 905-910
• 17 Maubon A J, Thurmond A S, Laurent A et al.. Selective tubal sterilization in rabbits: experience with a hydrogel combined with a sclerosing agent.  Radiology. 1994;  193 721-723
• 18 Maubon A J, Thurmond A S, Nikolchev J et al.. Endoscopic transvaginal approach to the rabbit uterine cervix: improvement in the technique of selective tubal catheterization.  Acad Radiol. 1997;  4 270-274
• 19 World Health Organization . Comparative trial of tubal insufflation, hysterosalpingography and laparoscopy with dye hydrotubation for assessment of tubal patency.  Fertil Steril. 1986;  46 1101-1107
• 20 Thurmond A S, Novy M, Rosch J. Terbutaline in diagnosis of interstitial fallopian tube obstruction.  Invest Radiol. 1988;  23 209-210
• 21 Hedgpeth P L, Thurmond A S, Fry R et al.. Radiographic fallopian tube recanalization: absorbed ovarian radiation dose.  Radiology. 1991;  180 121-122
• 22 Thurmond A S. Interpretation of pregnancies after selective salpingography.  Radiology. 1994;  190 11-13
• 23 Ferraiolo A, Ferraro F, Remorgida V et al.. Unexpected pregnancies after tubal recanalization failure with selective catheterization.  Fertil Steril. 1995;  63 299-302
• 24 Thurmond A S, Rosch J. Nonsurgical fallopian tube recanalization for treatment of infertility.  Radiology. 1990;  174 572-573
• 25 Kelekis D, Papageorgiou G, Fezoulidis I et al.. Selective transcervical recanalization of fallopian tubes: a method for diagnosis and treatment of infertility.  J Interv Radiol. 1992;  7 37-40
• 26 Maubon A, Rouanet J P, Cover S et al.. Fallopian tube recanalization by selective salpingography: an alternative to more invasive techniques?.  Hum Reprod. 1992;  7 1425-1428
• 27 Hayashi N, Kimoto T, Sakai T et al.. Selective fallopian tube catheterization: limited value in the treatment of fallopian tube diseases.  Radiology. 1994;  190 141-143
• 28 Hovsepian D M, Bonn J, Eschelman D J et al.. Fallopian tube recanalization in an unrestricted patient population.  Radiology. 1994;  190 137-140
• 29 Thurmond A S, Machan L S, Maubon A J et al.. A review of selective salpingography and fallopian tube catheterization.  Radiographics. 2000;  20 1759-1768
• 30 Papaioannou S, Afnan M, Sharif K. The role of selective salpingography and tubal catheterization in the management of the infertile couple.  Curr Opin Obstet Gynecol. 2004;  16 325-329
• 31 Thurmond A S, Jones M K, Mullick B et al.. Reversal of sterilization due to application of quinacrine by means of transcervical tubal catheterization.  J Vasc Interv Radiol. 1995;  6 147-149
• 32 Thurmond A S, Burry K A, Novy M J. Salpingitis isthmica nodosa: results of transcervical fluoroscopic catheter recanalization.  Fertil Steril. 1995;  63 715-722
• 33 Thurmond A S, Brandt K R, Gorrill M J. Tubal obstruction after ligation reversal surgery: results of catheter recanalization.  Radiology. 1999;  210 747-750
• 34 Society for Assisted Reproductive Technology of the American Fertility Society . Assisted reproductive technology in the United States: 1999 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry.  Fertil Steril. 2002;  78 918-931
• 35 Rawal N, Haddad N, Abbott G T. Selective salpingography and fallopian tube recanalisation: experience from a district general hospital.  J Obstet Gynaecol. 2005;  25 586-588
• 36 Das S, Nardo L G, Seif M W. Proximal tubal disease: the place for tubal cannulation.  Reprod Biomed Online. 2007;  15 383-388
• 37 Conceptus Inc .2007 Annual Report and Form 10-K. http://Available at: www.conceptus.com Accessed April 1, 2008
• 38 McSwain H, Brodie M F. Fallopian tube occlusion, an alternative to tubal ligation.  Tech Vasc Interv Radiol. 2006;  9 24-29