Hysteroscopic tubal cannulation: long‐term results

Abstract

ObjectiveTo examine the success rate and long‐term results of hysteroscopic cannulation under laparoscopic control for proximal fallopian tube obstruction.DesignRetrospective outcome analysis.SettingReferral endoscopic private practice for infertility.Subjects29 patients referred with proximal tubal cornual obstruction, confirmed by hysterosalpingography or laparoscopy, with other tubal factors confounding infertility. All patients underwent hysteroscopic proximal guide wire tubal cannulation under laparoscopic guidance.Main outcome measuresPregnancy outcomes from 2 to 5 years following the procedure.ResultsOf a total of 29 attempts at tubal cannulation, 16 were unsuccessful at the time of surgery (55%), while 13 patients had successful proximal tubal cannulation, and patency confirmed via intraoperative chromotubation. Of these 13, three were lost to long‐term follow up. Among the 10 remaining patients, there were three pregnancies: two term deliveries and one ectopic pregnancy. The remaining seven of the 10 patients with successful cannulations did not achieve pregnancy (70%) and elected for in vitro fertilization or adoption.ConclusionAfter over a decade of reports of hysteroscopic tubal cannulation, this procedure has been used as the first‐line, and often only, therapy for proximal tubal obstruction. The results of this series indicate that pregnancy rates are not as favourable as reported by others. These long‐term poor results should be considered when counselling patients with cornual occlusion about this surgery or other assisted reproductive options.