What Is Recanalization of Fallopian Tubes?

Recalanization of fallopian tubes is a procedure to remove a blockage using special catheters in a clinical setting. Blockage of the fallopian tubes (tubal factor infertility) is one of the most common causes of female infertility. The fallopian tubes are very fine tube-like structures that connect the ovaries to the uterus. The eggs from the ovary normally travel through the fallopian tubes where they can be met and fertilized by sperm. Sometimes, the tubes can become blocked or narrowed, preventing pregnancy. This can happen in one or both fallopian tubes.

Cause

• The most common cause of tubal factor infertility is pelvic inflammatory disease (PID). PID is a general term used to describe inflammation of the uterus, fallopian tubes and sometimes the ovaries. It is generally caused by repeated sexually transmitted infections such as chlamydia or gonorrhea (although this is not always the case). If left untreated, scar tissue can build up, leading to blocking of the fallopian tubes and infertility. One or both tubes can be blocked. If one is blocked, depending on the health of the ovary on that side, you may still be able to conceive naturally.

Other Causes

• Other causes of tubal factor infertility include endometriosis; previous ectopic pregnancy; previous abdominal surgery; history of infection caused by miscarriage or abortion and previous or current infection with gonorrhea or chlamydia. Although tuberculosis is relatively rare in the western world, it can cause infection in the fallopian tubes as can a ruptured appendix. All of these can cause scar tissue, mucus and debris to build up in the fallopian tubes which can lead to blockage.

Procedure

• During the procedure, in the X-ray department, you will be sedated and a speculum (a device used to open the vagina and view the cervix and surrounding tissue) will be inserted into your vagina in the same way as during a Pap smear. A tiny tube called a catheter is inserted through your cervix, into your uterus and to the fallopian tubes past the blockage. A special kind of dye is then quickly released. If the dye is seen on X-ray passing through the fallopian tube and into the pelvic cavity, there was no obstruction. If not, a tiny guidewire may be carefully passed through the catheter and manipulated to remove the blockage.

  An alternative to this method is inserting a small balloon through the catheter and gently inflating it at the site of the blockage. Recanalization can also be done surgically.

Effect

• An overview by the National Institute for Clinical Excellence says that if the blockage is close to the uterine entrance (proximal), then the blockage is removed in 70 percent of cases. Pregnancy is achieved in up to 20 percent of these cases.

Risks

• According to the National Institute for Clinical excellence, the main risks are perforation of the fallopian tubes (1 to 10 percent chance), intra-abdominal bleeding, infection (which is relatively rare) and ectopic pregnancy, where the pregnancy develops in the fallopian tubes and which happens 8 percent of the time.

Considerations

• If you have tubal factor infertility caused by endometriosis or pelvic inflammatory disease, your blockage is likely to be located further away from the entrance to the uterus (distal). This type of blockage is more difficult to treat with this technique, so your doctor is likely to discuss an alternative treatment with you.