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Results for “Fallopian Tube Patency Tests”

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PubMed1991

Return of reproductive performance after expectant management and local treatment for ectopic pregnancy.

The purpose of this study was to examine hysterosalpingographic findings and reproductive performance in patients previously managed non-surgically for ectopic pregnancy. Forty-nine patients with unruptured ectopic pregnancies were treated either by expectant management (n = 16) or medically (n = 33), using transvaginal methotrexate or sulprostone injection. The treatment was successful in 35 patients (71.5%), 12 out of 16 and 23 out of 33 in the two groups respectively. For all patients, follow-up currently varies from 3 to 52 months with a median follow-up of 16.6 +/- 11.2 months and 7.3 +/- 4.3 months in the two groups respectively. Hysterosalpingography was performed in 25 out of 26 patients who desired further pregnancy. We found evidence of tubal patency on the ectopic pregnancy treated side in 23 cases (92%). In this group, no recurrent ectopic pregnancy was observed. In the expectant management group, eight out of nine patients became pregnant, and the mean time to achieve pregnancy was 16.6 +/- 11.2 months. In the medical treatment group, eight out of 17 patients became pregnant and the mean time to achieve pregnancy was 8.6 +/- 4.2 months. In this last group, seven out of nine non-pregnant patients have had only a short follow-up, 4.5 +/- 3.2 months since treatment completion. No recurrent ectopic pregnancy was observed in this successfully treated group of patients who desired further pregnancy. We conclude that the medical approach to unruptured ectopic pregnancy is associated with a high rate of tubal patency and a reproductive performance similar to conservative surgical methods.

Adult↗
PubMed1993

Development of embryos from natural cycle in-vitro fertilization: impact of medium type and female infertility factors.

Single embryos derived from natural cycle in-vitro fertilization (IVF) were graded during the pre-transfer culture period using morphological criteria. Most embryos developed well in culture with 96% showing continuing division and 68% showing good morphological appearance, although embryo quality tended to decline with an increased incidence of fragmentation and uneven cleavage as division proceeded. Both the pregnancy rate and the distribution of embryo grades were similar among four different culture media used, suggesting that choice of medium had little impact on outcome. In contrast, there were marked differences in pregnancy rate according to the type of infertility, which was not reflected in a decrease in embryo quality. However, although embryos from patients with tubal infertility implanted and formed viable pregnancies irrespective of morphological appearance, only 'good' quality embryos from patients with non-tubal (or 'unexplained') infertility were able to implant. Thus the appearance of the embryo derived from natural cycle IVF in women with unexplained infertility may be of clinical relevance.

Adult↗
PubMed2002

One-stop endoscopy-based infertility clinic.

PURPOSE OF REVIEW: The investigation of the infertile couple is currently a highly debated issue. The purpose is to review whether transvaginal hydrolaparoscopy in combination with mini-hysteroscopy and chromopertubation can be offered as a one-stop infertility investigation. RECENT FINDINGS: The technique is based on the direct visualization of the reproductive organs and the presence of tubal patency, and has been clinically validated during the past year for its accuracy, safety and patient tolerance. SUMMARY: Further prospective randomized studies are required to prove the superiority of transvaginal hydrolaparoscopy in comparison with hysterosalpingography as a first-line investigation in predicting the fertility outcome.

Ambulatory Care Facilities↗
PubMed1988

Terbutaline in diagnosis of interstitial fallopian tube obstruction.

Effectiveness of terbutaline, a potent uterine muscle relaxant, for differentiation of temporary and anatomic interstitial fallopian tube obstruction (IFTO) at hysterosalpingography (HSG) was explored. In 43 IFTO evaluated, HSG after terbutaline showed patency in only one of 16 tubes in which IFTO was caused by spasm or other temporary cause. We conclude that terbutaline is not helpful in differentiating temporary from anatomic tubal obstruction during HSG.

Fallopian Tube Diseases↗
PubMed1986

Reevaluation of hysterosalpingography in infertility investigation.

The hysterosalpingogram has been extensively used in infertility investigations to assess tubal patency, however, the diagnostic reliability of this technique is not known. Two hundred thirty-one consecutive hysterosalpingograms were retrospectively evaluated. Sixty-two percent (143) of the patients subsequently underwent laparoscopy. Comparison of hysterosalpingogram and laparoscopic findings revealed a 15.9% false positive tubal patency rate and a 14.9% false negative tubal patency rate. Seventy-six percent of laparoscopies revealed previously undiagnosed intraperitoneal disease. Seventeen percent of hysterosalpingograms demonstrated intrauterine pathology. There was a 0.9% major complication rate with hysterosalpingograms due to two cases of acute pelvic inflammatory disease. No significant laparoscopic complications were noted. The results suggest that laparoscopy provides a more accurate assessment of tubal patency and peritoneal factors than hysterosalpingogram in the investigation of infertility.

Adolescent↗
PubMed1993

Transcervical tubal cannulation: a review.

Rapid progress has been made in the last 10 years regarding minimally invasive access to the human fallopian tube. Coaxial catheter systems are being used with hysteroscopy, fluoroscopy, ultrasonography, and tactile sensation to cannulate the fallopian tube transcervically with consistent success. Uterotubal obstruction viewed at the time of hysterosalpingogram can often be successfully cannulated with intrauterine pregnancies resulting. This review surveys all available published series of transcervical tubal cannulation with discussion of methodology, success in establishing patency, and the resultant pregnancy rates. It also describes how this technology has been applied to the intratubal deposition of gametes and embryos, direct visualization of the tubal epithelium, (falloposcopy), and contraception. Collectively, these techniques are defining tubal pathology more precisely, allowing us to prescribe the proper therapy.

Clinical Trials as Topic↗
PubMed1978

Tubal patency: hysterosalpingography compared with laparoscopy.

Laparoscopy was done about three months after hysterosalpingography (HSG) in 121 patients complaining of infertility. Normal patency was found with both technics in 71 patients (58.6%). In 23 of the 97 patients with a normal HSG, however, peritubal or tubal disease was observed at the time of laparoscopy (false-negative results, 19%). Twenty-four tubal obstructions (19.8%) were detected by HSG (16 distal and eight proximal) but five distal and four proximal obstructions were not confirmed by laparoscopy (false-positive results, 7.4%). In addition, laparoscopic evaluation demonstrated endometriosis in 31 cases, polycystic ovaries in six, and uterine fibroids in five.

Adnexal Diseases↗
PubMed1990

Pregnancy rates after the use of oil-based and water-based contrast media to evaluate tubal patency.

Hysterosalpingography (HSG) has assumed a diagnostic and possibly therapeutic role in the evaluation of the infertile couple. The procedure is done using either an oil-based (OBCM) or a water-based (WBCM) contrast medium. Data from several retrospective studies suggest that higher pregnancy rates may be achieved when OBCM is used. Interpretation of these results, however, may be confounded by various methodologic flaws in study design and comparisons of heterogeneous populations. We sought to compare the therapeutic benefit of OBCM and WBCM in a prospective randomized study of infertile patients, controlling for pelvic anatomy by laparoscopic assessment. We used ethiodized oil (Ethiodol) or iothalamate meglumine (Conray 60) for tubal lavage at the time of laparoscopy only in patients with normal pelvic anatomy. Of the 225 patients who had diagnostic laparoscopy in the evaluation of infertility, 40 (18%) had normal pelvic anatomy and an otherwise unremarkable evaluation. Adequate follow-up was available on 29 patients randomized to receive either OBCM (n = 15) or WBCM (n = 14). A significant difference in pregnancy rates was noted between OBCM (40%) and WBCM (14%) by chi-square analysis. No short- or long-term adverse reactions were noted. Results of this study suggest that in patients with normal pelvic anatomy as assessed laparoscopically, OBCM may offer a therapeutic benefit not evident with WBCM.

Contrast Media↗
PubMed2003

Pregnancy outcomes after fallopian tube recanalization: oil-based versus water-soluble contrast agents.

PURPOSE: To determine the pregnancy outcomes in patients undergoing fallopian tube recanalization (FTR) with use of oil-based versus water-soluble contrast agents. MATERIALS AND METHODS: Ninety-three patients with unilateral or bilateral proximal tubal occlusion confirmed by hysterosalpingography or laparoscopy underwent FTR with use of water-soluble contrast material alone (n = 50) or also had an oil-based agent injected into each tube after recanalization (n = 43). Pregnancy rates and outcomes of the two groups were studied retrospectively. RESULTS: With respect to differences between groups, only the body mass index proved to be a significant predictor (oil, 28.4; water, 24.7; P =.008). Mean age, duration of infertility, type of infertility, and initial diagnosis were comparable. There was a weak trend toward a higher pregnancy rate in the oil-based contrast material group, but it was not significant (P =.64). The average time to pregnancy was 4.4 months with use of oil-based contrast material, compared to 7.7 months with use of only water-soluble contrast material (P =.03). CONCLUSION: The use of an oil-based agent had little effect on the rate of conception, but time to conception was reduced by more than 3 months.

Adult↗
PubMed1998

Methemoglobinemia induced by methylene blue pertubation during laparoscopy.

Methylene blue is used to check tubal patency during laparoscopy. A case of methemoglobinemia which was induced by methylene blue is presented. Methemoglobinemia is usually treated with methylene blue; however, in patients with glucose-6-phosphate dehydrogenase deficiency, methylene blue can induce methemoglobinemia.

Adult↗
PubMedDate not supplied

Screening for infertility in Indonesia. Results of examination of 863 infertile couples.

During a five-year study, 863 infertile couples were examined by a quite simple screening procedure, adapted to the facilities or a rural hospital. Tubal obstruction, with an incidence of 45.4% appeared to be the most prominent cause of infertility. The second most important factor was poor semen quality, which accounted for 32.4%. Azoospermia was found in 12% of all semen samples, and a sperm count below 5 million/ml in 8.7%. Disturbances in ovulation were responsible for 13% of the infertility. Comparison of the causes of primary and secondary infertility demonstrated the greater role played by the semen factor in primary infertility and of the tubal factor in secondary infertility. Accordingly, the female-male ratio in secondary infertility was much higher than in primary infertility.

Fallopian Tube Patency Tests↗
PubMed1998

Microlaparoscopy for suspected pelvic pathology--a comparison of 2mm versus 10mm laparoscope.

This study presents an independently-assessed comparison of the laparoscopic view obtained using a 2mm versus 10mm laparoscope in women with suspected pelvic pathology. Fifteen female volunteers booked for laparoscopy with clinical evidence of pelvic abnormality according to clinical findings and/or pelvic ultrasound were recruited for this study. Sequential observations were carried out by independent observers for clinically significant differences. Although discrepancies were noted in 3 patients the view obtained with the 2mm microendoscope was considered to be comparable to that obtained with the 10mm telescope. The cases with discordant findings included mild or minimal endometriosis and distal tubal disease. The results of this study suggest that microendoscopy is likely to be entirely adequate for many routine laparoscopic procedures and sterilization.

Adult↗
PubMed2005

Prediction of laparoscopic surgery outcomes in tubal infertility.

This study aimed to elucidate the predictive value of hysterosalpingography (HSG) and laparoscopy (LS) scores for spontaneous pregnancy after laparoscopic surgery in 50 patients with tubal infertility. During a 1-year follow-up period, 28% of these patients became pregnant. Both scores were informative in prediction of pregnancy with the area under the ROC curve being 0.80 (95% CI 0.67-0.93) and 0.74 (95% CI 0.58-0.89) for LS and HSG scores, respectively.

Adult↗