Evaluation of Safety and Effectiveness for Hysteroscopically Assisted Falloposcopic Tuboplasty in Women with Proximal Tubal Infertility.

Abstract

Objectives: Tubal infertility accounts for approximately 30% of infertility cases in women. Falloposcopic tuboplasty (FT) is used in women with proximal tubal obstruction. However, it is technically challenging because of difficulties in locating the tubal ostium and confirming success. To address these challenges, we developed a hysteroscopically assisted FT (HA-FT). This study aimed to evaluate the efficacy of HA-FT in women with tubal infertility.

Materials and methods: This prospective unblinded study included infertile women with proximal tubal obstruction who desired a natural conception. HA-FT was performed under either intravenous or general anesthesia. Postoperative hysterosalpingography was performed in an operating room to confirm success. Success and pregnancy rates of HA-FT were compared with those of regular FT (Reg-FT).

Results: Regular FT (n = 73; 119 tubes) was performed before 2013, and HA-FT (n = 72; 136 tubes) was introduced thereafter. Patient characteristics were similar between the two groups. Operative time was not significantly different (Reg-FT: 37.7 ± 18.7 min vs. HA-FT: 44.3 ± 18.2 min). The success rate per patient was significantly higher in a HA-FT group (72/72,100%) than that in a Reg-FT group (63/73, 86.3%, P < 0.05). Similarly, success rate per tube was significantly higher for HA-FT (135/136, 99.3%) than that for Reg-FT (95/119, 79.8%; P < 0.01). Natural pregnancy rates were similar between the groups (HA-FT: 20/58, 34.4%; Reg-FT: 20/61, 32.7%).

Conclusion: HA-FT is a safe, effective, and reliable method for the treatment of proximal tubal obstruction. Its natural pregnancy rates are acceptable, making it a promising option for women with tubal infertility.