Infertility is the inability of a couple to conceive after one year of un- protected sex. One of the common cause of infertility is a blockage in fallopian tubes which are an important passage for the eggs produced by ovaries.
There can be many causes of Fallopian tube block including infections, tuberculosis or blockage due to impacted mucus plug or blood clots.
The blocks due to mucus plugs and clots just require clearing to open the tubes and one of the easiest way is by Fluoroscopy guided fallopian tube recanalization.
The procedure is done under in conscious state without any anaesthesia. Mild sedation can be given and the patient is discharged after a few hours.
The procedure is preferably done on eighth, ninth or 10th day of a woman’s menstrual cycle. This is to enable pregnancy to take place in the first cycle following recanalization.
Uterus is cannulated using a specialised uterine access canula through the vagina. Through this tube another catheter is passed into the uterine cavity and the opening to the fallopian tube is entered with the help of a guidewire. A brisk injection of contrast is made into the opening to flush out debris if present. Then a thin wire is manipulated through the tube to clear the debris.
Recanalization of these tubes is successful in close to 90% of the patient’s who present with cornual blocks [proximal 2 cm of the fallopian tube].
Blocks in other parts of the fallopian tube are usually secondary to infection and cannot be opened. The fallopian tubes may also be adhered outside due to infection or disease in which case only opening of the tube may not suffice.
About 40% of the patient’s who undergo successful tubal recanalization conceive within the first 6 months. However the male partner should be fully investigated and all abnormalities corrected before this procedure is taken up.
Tubes that have been recanalized may occlude again and then the procedure can be repeated.
Following the procedure the patient may have mild cramps and little bleeding for a few days. However all patients resume normal activities soon and are encouraged to have a normal sexual relationship with the husband.