Fallopian Tube Blockage Research Articles

ROLE OF VIRUDDHAHARA IN CAUSING INFERTILITY- A CONCEPTUAL STUDY

In the present era, many lifestyle disorders are caused by unhealthy food habits and practices; infertility is one of them. The incidence has increased due to diversified daily routines, faulty food habits, and westernization, which affect the endocrine system and physiological factors. These issues can cause irregular menstruation, ovulation disorders, PCOS, fallopian tube blockage, endometriosis, hormonal disorders, and uterine abnormalities, ultimately leading to infertility. The Ayurvedic explanation of ‘Viruddhahara’ is a unique concept. Acharya Charaka mentioned Shandhya and Santanadosha while listing the diseases caused by Viruddhahara1 . Viruddhahara impairs Rasadhatu, which leads to the Dushti of its upadhatu, Artava(Menstrual blood). Long-term practice of Viruddhahara (unhealthy food habits) causes Artavadushti and also affects the ovum, menstrual blood, and ovarian hormones. Viruddhahara significantly affects the Garbhasambhava samagri. The practice of Satmya Ahara and Vihara can help avoid multiple causative factors of infertility, such as Beeja dosha, Artava or Shukradushti, and yonivyapat. Infertility is also caused by obesity and other diseases resulting from faulty food habits.

ROLE OF TRIVIDHA AUSHADHA IN THE MANAGEMENT OF INFERTILITY DUE TO BILATERAL TUBAL BLOCKAGE AND ABNORMAL ENDOMETRIUM RECEPTIVITY ALONG WITH THE PREVENTION OF CONGENITAL ANOMALY: A CASE STUDY

Introduction: Infertility is the failure to naturally conceive a child even after one or more years of regular unpro-tected coitus. Primary infertility (absence of prior conception) and secondary infertility (infertility following at least one previous conception) are two categories under which infertility can be classified. Here, it is the case of secondary infertility caused by tubal and endometrial factors. Tubal factor and Endometrial factor come under four essential factors for conception described by Acharya Sushruta, i.e. Ritu, Kshetra, Ambu, Beeja as if the Kshetra is not formed correctly, it causes vandhyatva. In this case study, Ayurvedic management successfully treated secondary infertility caused by tubal and endometrial factors. Main clinical finding: A married Hindu female patient of 29 years of age visited OPD of the National Institute of Ayurveda, Jaipur, on 3 March 2021 with a chief complaint of wants issue since 1-year Diagnosis: Her HSG scan on 25 Feb 2021 suggestive of bilateral fallopian tube blockage. Her USG scan is suggestive of a simple cyst in her right ovary of size 31x19mm and endometrium thickness of 4mm on the 12th day of menses. Inter-ventions: Treatment given was Daivavyapashraya, Yuktivyapashraya (Ksheera basti, Uttarbasti and Yoga basti along with oral medication), and Satvavajaya. Outcome: She conceives after taking 20 months of treatment and delivered a healthy male child of weight 3.04kg on 21 July 2023 without any congenital anomaly. Conclusion: This case study shows the efficacy of Uttar Basti for treating bilateral tubal blockage and Ksheera Basti for en-hancing endometrial receptivity. It also highlights the significance of Daivavyapashraya, Yuktivyapashraya, and Satvavajaya Chikitsa in the management of infertility and the prevention of congenital anomalies.

Fertility after pouch surgery in women with ulcerative colitis: Is robotic surgery the key to better outcomes?

Fertility preservation is a major concern for women with ulcerative colitis who require surgical treatment. Previous studies have shown that the risk of infertility after restorative proctocolectomy is approximately four times higher. However, this risk appears to be lower in patients who undergo minimally invasive approaches, such as laparoscopic surgery. The benefits of laparoscopy have led to a debate on whether robotic-assisted surgery could offer better results in terms of fertility. Surgical robotic platforms can provide improved visualization of the pelvis and more precise dissection of anatomical structures. In theory, this could reduce tissue damage and the inflammatory response, leading to lower adhesion formation and fallopian tube blockage, thereby preserving fertility.

A Comparison of Hysterosalpingographic Results in Individuals Experiencing Primary and Secondary Infertility: A Prospective Approach

Introduction: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used in process of different investigations. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. This study aims to compare the HSG results in a study population having primary and secondary infertility.
 Materials and Methods: We conceded a one-year prospective study at Islamabad Diagnostic Center in Islamabad, Pakistan after getting institutional review board approval. The study duration was from July 1, 2022 to June 30, 2023. Sample size was calculated using online software “Raosoft” which estimated it to 242. All the patients who gave informed consent and having primary and secondary infertility were enrolled. Demographics of the patients including age, duration of infertility, and the presence of tubal and uterine abnormalities, were collected by reviewing clinical notes and X-ray findings.
 Results: Among 242 enrolled patients with infertility, the ratio of primary infertility was 70.27% (n=170) and that of secondary infertility was 29.75% (n=72). In both the groups, fallopian tube blockage was observed as a major abnormality that affected 20.00% (n=34/170) of patients with primary infertility and 30.55% (n=22/72) of patients with secondary infertility. Unilateral tube blockage was observed in 26.47% (n=9/34) whereas, bilateral blockage was observed in 29.41% (n=10/34) patients with primary infertility. 23.52% (n=8/34) of patients got affected with Bilateral hydrosalpinx, whereas unilateral loculated spill was perceived in 8.82% (n=3/34) of. In patients with uterine congenital abnormalities, 5.88% (n=2/34) had a bicornuate uterus, 2.94% (n=1/34) had a unicornuate uterus, and 2.94% (n=1/34) had uterine didelphys.
 Conclusion: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. In this study, fallopian tube abnormalities were most predominant among barren women. So, taking deterrent actions and efficiently management of pelvic infections are indispensable in plummeting the manifestation of infertility resultant of the tubal issues.
 Keywords: Hysterosalpingography, Infertility, Subfertility, Tubal blockage
 

A REVIEW ON ENDOMETRIAL RECEPTIVITY: BARRIER CROSS THROUGH AYURVEDA

Infertility – ‘inability for conception’ is a burning issue in the medical fraternity. Worldwide, the prevalence is increasing day by day. Many factors like ovulation disorders, uterine or cervical abnormalities, fallopian tube damage or blockage, endometriosis, pelvic adhesions, etc., contribute to female infertility. Defective or failed ‘Endometrial Receptivity’ (ER) is one among them. Ayurveda highlights ‘Vandhyatva’ as a failure to achieve live birth. Rutu, kshetra, ambu, and beeja are the 4 essential factors required for conception. Out of these, kshetra or garbhshayya is the most important as it is the site of implantation and abode for growing foetus. This article puts light on the concept of endometrial receptivity in relation to infertility.

Effect of Kumari Tail Uttarbasti on Fallopian tube blockage

Susruta has explained in detail about Garbha Sambhavasamagri (factors for conception). They are Ritu (fertile period), Kshetra (reproductive system - Artavavaha Srotas), Ambu (nourishment) and Bija (ovum and sperm). Derangement in these factors especially Artavavaha Srotas results Vandhyatva (infertility). Infertility is the inability to get pregnant (for whatever reason) after a year of unprotected sexual activity. About 10 to 15 percent of couples who are of reproductive age are affected. Tubal blockage is one of the most important factors for female infertility. This condition is not described in Ayurvedic classics, as the fallopian tube itself is not mentioned directly. The present study was carried out to evaluate the role of Uttar Basti in tubal blockage, in order to establish it as a safer and cost-effective Ayurvedic treatment modality.

Role of Viruddhahara in causing Infertility- A Conceptual Study

In present era, many lifestyle disorders are caused due to unhealthy food habits and practices, infertility is one among them. The incidence increased due to the diversified daily routine, faulty food habits, and westernisation which affects the endocrine system, physiological factors and causes irregular menstruation, ovulation disorders, PCOS, fallopian tube blockage, endometriosis, hormonal disorders and uterine abnormalities which ultimately leads to infertility. Ayurvedic explanation of ‘Viruddhahara’ is a unique concept. Acharya Charaka has mentioned Shandhya and Santana dosha[1] while listing the diseases caused due to Viruddhahara. Viruddhahara impairs Rasadhatu which leads to dushti of its upadhatu Artava. Long term practice of Viruddhahara/Unhealthy food habits causes Artavadushti, which affects ovum, menstrual blood and ovarian hormones. Viruddhahara greatly affects the Garbhasambhavasamagri. Practice of satmya Ahara and Vihara can avoid multiple causative factors of Infertility like Beeja dosha, Artava or Shukradushti, different yonivyapats. Infertility is also caused due to Mithyaachara as a complication of obesity and other diseases.

An Ayurvedic Approach in Infertility w.s.r to Tubal Blockage-A Case Report

Vandhyatva (infertility) is failure to conceive or give birth or experiencing Garbha Strava or Garbha pata (repeated abortion). Disturbed lifestyle, usage of contraceptives, stress, genetic problems, alcohol consumption and smoking addiction increases such cases day by day. Nowadays fallopian tube blockage has become one of the burning issues of female infertility. According to Ayurveda, successful conception depends upon Ritu, Kshetra, Ambu and Beeja. Beejagrahana is unable due to tubal blockage (Sanga Srotodusti of Arthavavaha) leads to failure of conception. Panchakarma plays an important role in treating female infertility and Uttara Basti is one of the best (Panchkarma therapy for the infertility treatment in Ayurveda.) It detoxifies the uterine cavity and fallopian tubes, which clear the Srothoavarodha. Uttarbasti along with internal medication helps in Vata Dosha saman and remove the Sanga srotodusti. A diagnosed case of infertility due to bilateral tubal blockage, visited our clinic for treatment of tubal blockage and consequent infertility. Here is the case presentation of successful treatment with Ayurveda medicines and Uttara basti.

Role of laparoscopy in hysterosalpingography diagnosed fallopian tube blockage in infertile females

Background: Hysterosalpingography (HSG) is routinely used as cost-effective method for the diagnosis of blockage in fallopian tube in infertile females. Laparoscopy involves a surgical procedure use to confirm the findings of HSG as well as has the therapeutic potential to remove the fallopian tube blockage. Aims and Objectives: The present study was aim towards analyzing the role of laparoscopy in HSG diagnosed fallopian tube blockage in infertile females. Materials and Methods: Total 48 infertile female who were diagnosed with the unilateral or bilateral fallopian tube blockage on HSG and planned for the laparoscopy was recruited in the study. Outcomes of the laparoscopy were analyzed. Results: Among total 48 patients, 26 patients (54%) presented with the bilateral blockage and remaining 22 patients (46%) presented with the unilateral blockage. Laparoscopy had a positive response in 20 (40%) patients with bilateral tubal block and 12 (26.7%) patients with unilateral block whereas the blockage remained in 16 (33.3%) cases. HSG was found to be false positive in two of cases. Conclusions: The present study revealed that the laparoscopy has great therapeutic potential in removal of fallopian tube blockage and is therefore affording patients should be advised to undergo laparoscopy. HSG due to low cost and short duration is more justifiable as a first line procedure. Therefore, is it recommended that the patients diagnosed with blockage in fallopian tube on HSG should be counseled for the laparoscopy. However, additional advantages of laparoscopy in diagnosing pelvic pathology should not be overlooked, thus benefits of laparoscopy cannot be replaced as of now.

The Correlation between Chronic Endometritis and Tubal-Factor Infertility

To identify the prevalence and risk factors for chronic endometritis (CE) with tubal factors and the correlation between chronic endometritis and tubal factors among infertile populations. A total of 52 patients with chronic endometritis (CE group) who underwent laparoscopy and hysteroscopic surgery were recruited between July 2020 and December 2021. A total of 38 patients without chronic endometritis (non-CE group) were included as a control. Patients with endometriosis and intra-uterine abnormalities were excluded. Endometrial samples were collected during surgery for CD138 immunohistochemistry staining for the diagnosis of CE. Preoperative information (including age, reproductive health characteristics, previous medical and surgical history), intra-operative information (including the patency of the fallopian tube, the presence of hydrosalpinx, score and the grade of tubal lesion condition) and post-operative information (counts of CD138-positive HPF in the endometrial specimen) were collected. A multivariate analysis revealed that tubal factors with unilateral or bilateral occlusion were significantly higher in the CE group (OR 3.066, 95% CI 1.020-9.213, p = 0.046). The bilateral occlusion of fallopian tubes (OR 8.785, 95% CI 1.408-54.818, p = 0.020) rather than unilateral occlusion (OR 2.860, 95% CI 0.893-9.162, p = 0.077) was significantly associated with chronic endometritis. The presence of a hydrosalpinx on one side (OR 7.842, 95% CI 1.279-48.086, p = 0.026) or both sides (OR 9.450, 95% CI 1.037-86.148, p = 0.046) was significantly associated with chronic endometritis. The comparison of CD138-positive HPF counts among the tubal occlusion patients without hydrosalpinx, patients with unilateral hydrosalpinx and patients with bilateral hydrosalpinx were as follows: 1 HPF (50.00% vs. 12.50% vs. 11.11%, p = 0.051), 2 HPF (38.89% vs. 25.00% vs. 22.22%, p = 0.615), ≥3 HPF (11.11% vs. 62.50% vs. 66.67%, p = 0.005). The stage of tubal condition was positively correlated with CD138-positive HPF counts in women with chronic endometritis (r = 0.460, p = 0.001). CE was closely related to the blockage of fallopian tubes and hydrosalpinx. The severity degree of the fallopian lesion condition was associated with inflammation of the endometrium.

Immune disturbances in female genital tuberculosis and latent genital tuberculosis.

Female genital tuberculosis (FGTB), an important clinical sub-type of extra-pulmonary tuberculosis (EPTB) is responsible for about 10% cases of infertility in India. Both FGTB and latent genital tuberculosis (LGTB) can cause infertility through blockage of fallopian tubes and through altered uterine endometrial receptivity. This review tries to elucidates the role of various immune factors in FGTB and LGTB. Various immune disturbances are observed in FGTB and LGTB like growth factors and cytokines which inhibit implantation and several inflammatory signaling pathways like mitogen activated protein kinase (MAPK), natural killer (NK) cells, nuclear factor kappa-B (NF-KB), tumor necrosis factor (TNF), and toll like receptors (TLR) signaling are dysregulated. These altered immune factors and pathways may be detected in the endometrial biopsies at the early stages of disease before permanent damage. Prompt and adequate treatment with the four anti-tubercular drugs (rifampicin [R], isoniazid [H], pyrazinamide [Z], and ethambutol [E]) can increase pregnancy rates in some of these women. Assisted reproduction especially in-vitro fertilization and embryo transfer may be required for some women. Inflammatory pathways identified from the gene profiling have enabled development of potential biomarkers for early diagnosis of FGTB. Immunomodulation and novel biotechniques like stem cell transplantation, nanoparticles and host directed therapies are being tried in selected patients of FGTB and LGTB with promising results.

Frequency Of Hysterosalpingography Findings In Females Presenting With Infertility In Gujrat

Background: Infertility is a gynecological illness which has clinical, financial and psychological consequences that affects 1.3% to 25.7% of couples throughout the world. Hysterosalpingography is a typical imaging technique used in gynecological practice to diagnose infertility in women. 
 Aim And Objective: The objective of our study was to evaluate the frequency of Hysterosalpingography findings in females presenting with infertility in Gujrat.
 Methodology: The prospective cross sectional study was carried out at X-Ray unit in Azeem Ultrasound & Digital X-Rays center, Gujrat, Pakistan. A total of 90 females patients with infertility were enrolled in present study. The duration of this research work was from February 2022 to May 2022. The data was gathered using a predesigned questionnaire form.. Statistical Package of Social Sciences was used to analyze the data. Frequency of different findings was found out. These were then graphically portrayed in the form of tables and graphs. 
 Results : We observed 90 female patients out of which 72 (80%) patients found to be normal. In 18 (20%) patients fallopian tube blockage was diagnosed. Out of 18 patients, 8 (8.9%) were having right sided fallopian tube blockage, 8(8.9%) were having bilateral tubal blockage while only 2 (2.2%) showed left sided tube block. Hydrosalpinx was found in 4(4.4%) patients and uterine anomaly in 2(2.2%) patients.
 Conclusion: Fallopian tube blockage and hydrosalpinx were common factors of infertility in our study. Hysterosalpingography provides an easy and affordable source for evaluation of infertility factors.

Management of tubal blockage through Ayurvedic interventions

INTRODUCTION: Fallopian tube blockage is among the most notorious factors for female infertility, which is responsible for 25%–30% of total female infertility. Tubal blockages can be correlated to Sanga Srotodushti of Artavavaha Srotasa in Ayurveda, involving Vata and Kapha Doshas. Normalizing the vitiated Vata–Kapha Dosha leads to restoration of tubal function and easy conception. The case report presented here highlights the role of Ayurvedic medicines and therapies in successfully managing tubal blockage. MATERIALS AND METHODS: In the present case report, a 27-year-old married female diagnosed with infertility due to bilateral fallopian tube blockage presented with chief complaints of inability to conceive for 3 years and was treated with Ayurveda medications and therapeutic procedures. Oral medicines such as decoctions, herbal powder, medicated ghee, and tablets were administered along with therapeutic procedures, which included Virechana (therapeutic purgation), Basti (therapeutic enema), and Uttarbasti (intrauterine medication). Pre- and post-assessments were done by hysterosalpingography (HSG). RESULT AND CONCLUSION: At the end of the treatment, there was a normal spillage of dye in both tubes noted in HSG. In this study, a comprehensive therapeutic intervention using Ayurveda medications and therapeutic procedures such as Virechana, Basti, and Uttarbasti was found to effectively clear the blockage of tubes.

Homoeopathic management of infertility due to blockage of fallopian tube – A case series

Introduction: Infertility is characterised by the failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. The prevalence of infertility in the general population is about 9–18%. Out of several causes of infertility, the tubal factor plays a role in 15.4% of cases. Homoeopathy is a gentle and effective mode of treatment. A few previous studies indicate that homoeopathy is a useful method of treatment for the treatment of infertility cases. Cases Summary: Four cases of female infertility due to blockage of fallopian tubes treated at Dhabaleswar Homeo Clinic, Cuttack, are presented herewith. The cases were treated successfully with individualised homoeopathic medicines. After the treatment, all patients conceived normally and delivered healthy babies. The medicines used were Sepia, Sulphur and Medorrhinum in centesimal potencies. Difficult cases of infertility with fallopian tube blockage are thus treatable and women can attain pregnancy with the help of homoeopathic treatment.

ЖЕНСКИЙ ГЕНИТАЛЬНЫЙ ТУБЕРКУЛЕЗ, БЕРЕМЕННОСТЬ ПОСЛЕ ЭКСТРАКОРПОРАЛЬНОГО ОПЛОДОТВОРЕНИЯ

The article describes a clinical observation of timely detected and treated female genital tuberculosis (FGTB) in an immunocompetent woman with tubal-peritoneal infertility before enrollment in the in vitro fertilization (IVF) programme. We have outlined diagnostic features of the disease, its association with the history of pulmonary TB, primary methods of examination, and treatment principles in FGTB. The examination included controlled simulation of ovulation, sonography, laparoscopy, hysteroscopy, pathomorphological studies, X-ray and computed tomography of the chest, endometrial biopsy. We also performed Ziehl–Neelsen microscopy of sputum, endometrium; luminescent microscopy; inoculation of endometrium, menstrual blood, and sputum onto solid and liquid nutrient media. We described successful pregnancy after IVF in a patient with tubal-peritoneal infertility due to FGTB after TB treatment. We concluded how important was to consider TB as a possible cause of bilateral fallopian tube blockage. Success and safety of IVF was preconditioned by timely detection and treatment of TB in the fallopian tubes, the endometrium, and the abdomen, as well as thorough monitoring of the reproductive organs.

Is Chronic Endometritis Associated with Tubal Infertility? A Prospective Cohort Study

Chronic endometritis (CE), which often presents asymptomatically, is associated with recurrent pregnancy loss, recurrent implantation failure after in vitro fertilization, and endometriosis. Data connecting CE with fallopian tubal occlusion are limited. The aim was to assess a potential association of CE, defined by the presence of syndecan-1 (CD138)-positive plasma cells in endometrial tissue samples, with fallopian tube patency and other factors for infertility, including endometriosis, adenomyosis, and hydrosalpinges. Prospective, monocentral pilot study. Tertiary care center. A cohort of 100 women who were infertile was enrolled from July 2019 to December 2020. Hysteroscopy with endometrial biopsy and laparoscopy with chromopertubation. CE was found in 13 women (13.0%) and was associated with endometriosis (p=.034) and unilateral/bilateral fallopian tube blockage (p=.013). In women with endometriosis, the mean number of CD138-positive cells was positively correlated with the revised American Society for Reproductive Medicine score (r = .302, p = .028). In a binary regression model, the presence of a hydrosalpinx on one or both sides (odds ratio 15.308; 95% confidence interval, 1.637-143.189; p = .017) and the finding of CE in the endometrial tissue sample (odds ratio 5.273; 95% confidence interval, 1.257-22.116; p = .023) were significantly associated with fallopian tubal occlusion. CE was significantly associated with blockage of the fallopian tubes and endometriosis. Endometriosis stage was associated with the number of CD138-positive cells in endometrial biopsies.

MANAGEMENT OF FEMALE INFERTILITY DUE TO TUBAL BLOCKAGE BY AYURVEDIC TREATMENT PROTOCOL: A CASE REPORT

Motherhood is one of those transforming experience which can’t quite put into words. Infertility represents a major crisis for most couples, with both partners experiencing loss in ways that affect them as individu-als, as family members and as members of society as a whole. Tubal factor is second major cause of fe-male infertility. In Tubal factor, modern management are dependent on Tubal Surgery or IVF or Embryo Transfer. All these methods are the solution only for the anatomical aspect of the tube and no success in establishing the tubal function. The present case report revealed effect of Virechana and Uttarbasti karma in a known case of secondary infertility due to Fallopian Tube Blockage. Virechana is indicated in Vandhyatva and Yonivyapada chikitsa. Uttarabasti is a very important and unique Ayurvedic procedure, which is mentioned for the genito–urinary problems. Successful conception occurs after this treatment.

Laparoscopic tuboplasty for mild distal tubal disease

To review tuboplasty techniques for alleviating fallopian tube blockage. A step-by-step explanation of the techniques that comprise tuboplasty-fimbrioplasty, salpingo-ovariolysis, and salpingostomy-with surgical video footage. Academic medical center. A 28-year-old G0 female patient with primary infertility and bilateral fallopian tube occlusion wanting to avoid invitro fertilization. Tuboplasty and its component techniques of fimbrioplasty, salpingo-ovariolysis, and salpingostomy are demonstrated in a stepwise fashion for a case of mild tubal disease. Fimbrioplasty includes identifying the agglutinated or phimosed fimbrial end and gently opening it with fine forceps and blunt microdissection. Salpingo-ovariolysis is demonstrated with video and comprises: 1) surveying the anatomy; 2) applying traction to delineate the adhesions; and 3) transecting the adhesions with microsurgical scissors or electrosurgery. Finally, the steps of a salpingostomy are demonstrated, including: 1) identifying the length of the fallopian tube; 2) performing chromotubation to delineate tubal obstruction; 3) creating a salpingostomy at the terminal end; and 4) suturing open the salpingostomy site circumferentially to evert the edges. Successful restoration of normal tubal anatomy and identification of the location of tubal occlusion to guide salpingostomy site placement. The fallopian tubes were assessed bilaterally and noted to have mild tubal disease and therefore were appropriate for tuboplasty. Normal tubal anatomy was restored bilaterally through salpingo-ovariolysis. Subsequent identification of the area of tubal occlusion bilaterally and salpingostomy were performed to create a patent fallopian tube able to pick up an oocyte from the ovary and facilitate fertilization. Tubal reconstructive surgery remains an important option to offer patients who want to avoid invitro fertilization and who have mild tubal disease.

How and Why to Define Unexplained Infertility?

Unexplained infertility represents up to 30% of all cases of infertility. It is a diagnosis of exclusion, where no cause for infertility may be identified in the investigation of the couple, be it anovulation, fallopian tube blockage, or severe male factor. Unexplained infertility therefore cannot be considered a diagnosis to which a specific treatment is directed, rather that it indicates a failure to reach a diagnosis of the true cause of infertility. In this review, we explore the evidence base and potential limitations of the current routine infertility assessment. We also aim to highlight the importance of considering the prognosis of each individual couple through the process of assessment and propose a reconsidered approach to treatment, targeted to the prognosis rather than the diagnosis. Ultimately, a better understanding of the mechanisms of infertility will reduce the number of couples diagnosed with "unexplained" infertility.

1931 Laparoscopic Tuboplasty

Video Objective To review tuboplasty techniques for alleviating fallopian tube blockage. Tuboplasty consists of fimbrioplasty, salpingo-ovariolysis and salpingostomy. Setting A 28yo G0 female patient with primary infertility and bilateral fallopian tube occlusion seen at an urban tertiary care hospital. Interventions There are several techniques for alleviating blockages and reconstructing the fallopian tubes which are collectively referred to as tuboplasty. Tuboplasty can be further subdivided into fimbrioplasty, salpingo-ovariolysis, and salpingostomy. Such procedures are performed by experts in tubal reconstruction and with the increasing prevalence of in vitro fertilization, there is less exposure to these techniques. We review a case of bilateral tubal occlusion which was managed with salpingo-ovariolysis and salpingostomy. The steps of salpingo-ovariolysis and salpingostomy are reviewed and demonstrated through video. Studies have reported live birth rates following salpingostomy between 20-37% and in cases of mild tubal disease, live birth rates increase up to 40-60%. Conclusion Tubal reconstructive surgery remains an important option to offer patients who want to avoid in vitro fertilization and who have mild tubal disease.