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Human Reproduction, Vol. 18, No. 2, 358-363, February 2003
© 2003 European Society of Human Reproduction and Embryology

The potential value of tubal perfusion pressures measured during selective salpingography in predicting fertility

Spyros Papaioannou1,5, Masoud Afnan1, Alan J. Girling4, Aravinthan Coomarasamy2, Josephine M. McHugo3 and Khaldoun Sharif1

1 Assisted Conception Unit, 2 Education Resource Center and 3 Department of Radiology, Birmingham Women’s Hospital, Metchley Park Road, Birmingham B15 2TG and 4 School of Mathematics and Statistics, University of Birmingham, Birmingham B15 2TT, UK

5 To whom correspondence should be addressed: 142, Harborne Park Road, Harborne, Birmingham B17 0BS, UK. e-mail:spyrospap{at}talk21.com

BACKGROUND: The value of tubal perfusion pressures assessed during selective salpingography and tubal catheterization in predicting fertility has not been investigated. METHODS: A total of 325 infertile women underwent selective salpingography and tubal catheterization. Pregnancy information was collected in 256 (78.7%). The 50th (300 mmHg) and 90th (500 mmHg) centiles of the tubal perfusion pressure distribution in women with normal tubes on selective salpingography were used as thresholds. Women were divided into three tubal perfusion pressure groups: good (both tubes <300, or one tube <300 and the other 300–500 mmHg), mediocre (both tubes 300–500, or one tube <300 and the other >500 mmHg) and poor (both tubes >500, or one tube > 500 and the other 300–500 mmHg). RESULTS: The pregnancy rate in the good perfusion pressure group was significantly higher than that in the poor perfusion pressure group, both when all non-IVF/ICSI first conceptions (P = 0.001) as well as when spontaneous first conceptions only were considered (P = 0.010). The pregnancy rate in the mediocre group lay between the good and the poor groups, though none of the comparisons reached statistical significance. CONCLUSIONS: Selective salpingography can provide additional diagnostic information in comparison with other tubal assessment tests. Tubal perfusion pressures may be predictive of future fertility.

Key words: infertility/selective salpingography/tubal catheterization/tubal perfusion pressures


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