Amy Suzanne Thurmond MD, Presenter: Nothing to Disclose

1) Appreciate the history of transcervical tubal catheterization for blocking, and unblocking the fallopian tubes. 2) Develop a plan for integrating tubal catheterization into an interventional radiology practice. 3) Understand the strengths and limitations of the technique, as well as the risks, pitfalls, and costs.

There are two indications for fluoroscopic fallopian tube catheterization. The first is treatment of proximal tubal occlusion causing infertility. For the treatment of proximal tubal occlusion, results since the late 1980s from centers worldwide have shown that catheter recanalization is possible in about 90% of women using angiographic techniques learned during residency training. The pregnancy rate following fallopian tube recanalization can be as high as 60% without any other intervention. The underlying cause of the obstruction is usually accumulated debris. The American Society for Reproductive Medicine has recommended that women in whom the hysterosalpingogram demonstrates proximal tubal occlusion undergo fallopian tube catheterization with selective salpingography prior to more invasive and more costly diagnostic tests and infertility treatments. The second indication is for sterilization, to prevent unwanted pregnancy, and these procedures are in their developmental stages. The ESSURE coil (Conceptus, Inc), and the Adiana device (Hologic, Inc.), have both been FDA approved for tubal sterilization by hysteroscopic placement. In some areas, radiologists are being asked to assist with this procedure or to place the coils fluoroscopically through fallopian tube catheterization.  

Thurmond, A, Recanalization and Occlusion of Fallopian Tubes.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9000556.html