Diagnostic and therapeutic value of selective salpingography and tubal catheterization in an unselected infertile population.

OBJECTIVE

To present diagnostic findings and fertility outcome after selective salpingography and tubal catheterization in an unselected infertile population.

DESIGN

Cohort study.

SETTING

Tertiary reproductive medicine unit.

PATIENT(S): One hundred ten consecutive infertile women. No exclusion criteria were applied. Follow-up ranged from 16 to 54 months.

INTERVENTION(S): Selective salpingography and tubal catheterization under fluoroscopic guidance as the primary test for the assessment of the fallopian tubes.

MAIN OUTCOME MEASURE(S): Incidence of tubal disease at selective salpingography, therapeutic effectiveness of tubal catheterization, and fertility outcome after the procedure.

RESULT(S): Tubal disease was present in 31.4% of the tubes examined. Of tubes proximally blocked at selective salpingography, 52.1% were found to be normal after tubal catheterization. Proximal tubal blockage (bilateral or unilateral) was detected in 34.8% of women. This was reduced to 5.5% after tubal catheterization. Spontaneous conceptions occurred in 21.9% of the women. In total, 36.2% conceived without IVF or ICSI.

CONCLUSION(S): Selective salpingography and tubal catheterization can be useful as a primary tubal assessment tool in the investigation of infertility. In cases of proximal tubal blockage, an effective see-and-treat approach can be adopted. More research into the possible therapeutic benefits of the procedure is justified.