Factors affecting the success of fallopian tube recanalization in treatment of  tubal obstructive infertility

Huawei Shen; Mingjin Cai; Tingwei Chen; Duzhou Zheng; Shikuan Huang; Mimi Zhou; Wanling He; Yongsen Li; Qianyan Tan

doi:10.1177/0300060520979218

Infertility Tubal Factor

Factors affecting the success of fallopian tube recanalization in treatment of tubal obstructive infertility

Shen H, Cai M, Chen T, Zheng D, Huang S, Zhou M, He W, Li Y, Tan Q

Published December 17, 2020 The Journal of International Medical Research, 48(12), 300060520979218

DOI 10.1177/0300060520979218 PMID 33322979 PMC PMC7745608

RRM Academy Synopsis

Age, infertility type and surgical history linked to tube reopening

Six factors were each linked to an open tube afterward, a review of 762 women at one hospital found. All had a blocked tube. The six were age, infertility type, years trying, and past ectopic pregnancy, belly surgery and abortion curettage.

Study at a glance, retrospective review of 762 women: Age, infertility type and surgical history were linked to an open tube. Source: Shen H et al., 2020, PMID 33322979.

Key Findings

The 762 women were treated between January 2016 and December 2018. Mean age was 31.6 ± 5.6 years, and mean duration of infertility was 4.2 ± 2.7 years.
Primary infertility affected 38.8% and secondary infertility affected 61.1%. Interstitial obstruction affected 60.9%, and obstruction of the isthmus affected 39.1%.
Age had an OR = 2.38 (95% CI: 1.24–4.58), infertility type an OR = 2.82 (95% CI: 1.36–6.21), and duration of infertility an OR = 2.03 (95% CI: 1.06–3.85).
History of ectopic pregnancy had an OR = 7.87 (95% CI: 4.05–15.81) and abdominal surgery an OR = 4.30 (95% CI: 2.22–8.60).
History of artificial abortion curettage had an OR = 4.08 (95% CI: 2.12–8.03). All six ORs came from the multivariable model.

Interpretation

This retrospective review followed 762 women treated for a blocked fallopian tube at one hospital, from 2016 to 2018. Six factors were each linked to whether the tube stayed open afterward: age, infertility type, time spent trying to conceive, prior ectopic pregnancy, prior belly surgery and prior abortion curettage. Prior ectopic pregnancy had the strongest link. Prior belly surgery and prior abortion curettage came next. The authors point to selection and information bias as limits of the retrospective design. The findings support larger studies across more hospitals.

RRM Context

Restorative reproductive medicine looks for the cause of tube damage. The authors link scarring after pelvic surgery and abortion curettage to blocked tubes. Adhesion prevention at surgery targets that scarring. A full history includes pelvic surgery, ectopic pregnancy and curettage. Both partners get evaluated.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To examine potential risk factors associated with the success rate following fallopian tube recanalization (FTR) in infertile women with obstruction of the proximal fallopian tube.

Methods

We retrospectively studied patients who underwent FTR for tubal obstructive infertility between January 2016 and December 2018 at the Third Affiliated Hospital of Guangzhou Medical University. FTR was performed using a catheter and guidewire system to clear tubal obstruction. Predictive factors potentially associated with the success rate were assessed by logistic regression.

Results

A total of 762 patients were included. Multivariable analysis showed that age (odds ratio [OR] = 2.38, 95% confidence interval [CI]: 1.24-4.58), infertility type (OR = 2.82, 95% CI: 1.36-6.21), history of ectopic pregnancy (OR = 7.87, 95% CI: 4.05-15.81), history of abdominal surgery (OR = 4.30, 95% CI: 2.22-8.60), history of artificial abortion curettage (OR = 4.08, 95% CI: 2.12-8.03), and duration of infertility (OR = 2.03, 95% CI: 1.06-3.85) were independently associated with postoperative tubal patency.

Conclusions

Our findings suggest that risk factors, such as age ≥35 years, secondary infertility, duration of infertility ≥5 years, and histories of ectopic pregnancy, abdominal surgery, and artificial abortion curettage, affect the success rate of FTR. These factors may also predict surgical success in treating tubal obstructive infertility.

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Fertility-Preserving Surgery: Restorative, Specialist, and Conventional Approaches Compared

Topics

Infertility › Tubal Factor › Proximal Tubal Obstruction · Reproductive Surgery › Tubal Surgery › Tubal Cannulation

Huawei Shen, Mingjin Cai, Tingwei Chen, Duzhou Zheng, Shikuan Huang, Mimi Zhou, Wanling He, Yongsen Li, Qianyan Tan

H Shen, M Cai, T Chen, D Zheng, S Huang, M Zhou, W He, Y Li, Q Tan

PMID 33322979 33322979 DOI 10.1177/0300060520979218 10.1177/0300060520979218 Shen et al. 2020, Shen 2020

Factors affecting the success of fallopian tube recanalization in treatment of tubal obstructive infertility

Age, infertility type and surgical history linked to tube reopening

Key Findings

Interpretation

RRM Context

Abstract

Read the guide

Topics

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