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Human Reproduction, Vol. 17, No. 8, 2174-2179, August 2002
© 2002 European Society of Human Reproduction and Embryology

The effect on pregnancy rates of tubal perfusion pressure reductions achieved by guide-wire tubal catheterization*

Spyros Papaioannou1,4, Masoud Afnan2, Alan J. Girling3, Aravinthan Coomarasamy2, Bolarinde Ola2, Olufemi Olufowobi2, Josephine M. McHugo2, Nahed Hammadieh2 and Khaldoun Sharif2

1 12 Metfield Croft, Harborne, Birmingham B17 0NN, 2 The Assisted Conception Unit, Birmingham Women's Hospital, Metchley Park Road, Birmingham B15 2TG and 3 School of Mathematics and Statistics, University of Birmingham, Birmingham B15 2TT, UK

BACKGROUND: Selective salpingography enables us to measure the Fallopian tube perfusion pressure which, when high, can be effectively reduced with the use of transcervical guide-wire tubal catheterization. Whether fertility prognosis improves as a result is currently unknown. Our objective was to clarify the issue. METHODS: Infertile women undergoing selective salpingography were classified into poor, mediocre and good tubal perfusion pressure groups, based on the distribution of tubal perfusion pressures in an unselected infertile population. Of 325 women, 150 (46.1%) were classified in the poor group and underwent guide-wire tubal catheterization. RESULTS: Complete pregnancy and tubal perfusion pressure data were available for 104 (69.4%) subjects. Following tubal catheterization, 29 women (group A) could be classified in the good, 25 (group B) in the mediocre, while 50 women (group C) remained in the poor tubal perfusion pressure group. Survival analysis showed that the pregnancy rate in group A was significantly higher than the rates in groups B and C (P = 0.036 and 0.005 respectively). CONCLUSIONS: Reductions of tubal perfusion pressures achieved with transcervical guide-wire tubal catheterization resulted in an improved fertility prognosis for women. Selective salpingography and tubal catheterization might have a wider role in the management of the infertile couple than currently believed.

Key words: infertility/proximal tubal obstruction/selective salpingography/tubal catheterization/tubal perfusion pressure

4 To whom correspondence should be addressed. E-mail: spyrospap{at}talk21.com

* This study was partly funded by Cook Australia, Brisbane


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