Abstract
To prospectively study the efficacy of different anti-adhesion agents for the prevention of tubal obstruction after recanalization, this trial was approved by our hospital ethics committee. Four hundred patients with fallopian tube obstruction were randomly assigned to four groups. The control group underwent recanalization alone, whereas the other groups were injected with chitosan, Dan-shen, or combined chitosan and Dan-shen after recanalization. The tubal patency rate in all four groups was recorded after 12 day, 3 months, and 12 months. The pregnancy rates were noted after 12 months. The recanalization rates after 1 day in the control, chitosan, Dan-shen, and combined chitosan and Dan-shen groups were 94.1, 97.1, 96.5, and 98.2%, respectively (p = 0.18, p > 0.05). The rates of tubal patency after 3 months were significantly higher in the combined chitosan and Dan-shen (96.5%), chitosan (88%), and Dan-shen (85.2%) groups compared with the control group (73.9%) (p = 0.0001, p < 0.05). The recanalization rate and intrauterine pregnancy rate after 12 months was significantly higher in the combined chitosan and Dan-shen group (93.8 and 63.9%, respectively) compared with the other groups (control 39 and 30.6%, chitosan 78.4 and 46.9%, and Dan-shen 77.3 and 43.3%) (p = 0.0029 and p = 0.0001, p < 0.05). Chitosan, Dan-shen, or a combination of the two compounds could be effective for preventing tubal obstruction after interventional recanalization, possibly increasing the rate of pregnancy in affected women. The combined chitosan and Dan-shen injection has unique advantages in the interventional recanalization of obstructed fallopian tubes.
Highlights
The global rate of infertility in women is approximately 15.5% and the incidence is increasing [1]
We investigated the application of the chitosan injection, Dan-shen injection, and combined chitosan and Dan-shen injection for fallopian tube recanalization, in addition to the mechanism used by the combined chitosan and Dan-shen injections to prevent and cure postoperative tubal re-occlusion and promote the synergistic effect of tissue repair
Twelve of the enrolled patients were lost to follow-up, including two in the control group, four in the chitosan injection group, three in the Dan-shen injection group, and three in the combined chitosan and Dan-shen injection groups
Summary
The global rate of infertility in women is approximately 15.5% and the incidence is increasing [1]. Fallopian tube obstruction can lead to reduced fertility among affected women, accounting for 25 to ~ 35% of all causes of infertility [2]. These causes include chronic salpingitis and sexually transmitted diseases (STDs), and adhesions caused by uterine and abdominal cavity surgery. Selective salpingography is conducted using a coaxial catheter directed over a guide wire, followed by interventional recanalization for tubal obstruction. Postoperative re-occlusion of the fallopian tube lumen can readily occur due to its complicated pathology, resulting in a low rate of intrauterine pregnancy following the treatment [4]
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