A proximal fallopian tube occlusion is often due to the accumulation of mucus or debris forming a plug in the proximal portion of the tube. This may happen in both tubes or simply in one of the two fallopian tubes. Patients with a proximal occlusion benefit from the Fallopian tube recanalization procedure.
In fact, the American Society for Reproductive Medicine has recommended that patients who have proximal tubal obstruction undergo this procedure prior to any other more invasive procedures.
The contraindications of the procedure are active uterine bleeding, active pelvic infection, recent surgery and current pregnancy.
It should be performed at approximately day six to eleven of the menstrual cycle which is after the cessation of menses and before ovulation.
The Fallopian tube recannulization procedure begins with a standard hysterosalpingogram to evaluate the patency of the fallopian tubes. A speculum is inserted into the vagina to see the cervix. The cervix is then prepped sterilely and a catheter is passed into the cervix to the Fallopian tube. If the Fallopian tube is occluded a small guidewire (approximately l/40th of an inch) is advanced through the tube to open it up. Contrast is then injected to demonstrate spillage into the peritoneal cavity.
This is all done obviously with no incisions and small catheters are used. From the patient perspective this is similar to a hysterosalpingogram. Mostly because this procedure lasts longer than a standard hysterosalpingogram, we do use sedation at Northside Hospital. Because of the use of sedation all patients are asked not to eat beginning at midnight the night before the day of the procedure. The procedure usually lasts approximately 30 minutes and we often have the patient stay approximately 2-4 hours after the procedure prior to going home.
If patency can be restored during the procedure which occurs in approximately 65-90 percent of cases reported conception rates in the literature are approximately 33 percent. A small proportion of the patients re-occlude their Fallopian tubes and require a repeat procedure about 8 months to 1 year later.
Serious Fallopian tube recanalization complications are extremely rare. Mild bleeding and fallopian tube perforation can occur but are usually without sequelae. Infections and contrast reactions can occur as well but again are very rare. Sometimes after Fallopian recanalization there is slight increased risk of an ectopic pregnancy.
You can reach the Scheduling Department by calling 404-851-6577 or you can request and appointment and more information here through our website. Complete our online appointment request and one of our program coordinators will contact you to discuss.