Study Shows Potential for Selective Salpingography and Fallopian Tube Recanalization in Female Infertility

June 8, 2022—The Society of Interventional Radiology (SIR) announced findings demonstrating that a diagnostic procedure known as selective salpingography followed by fallopian tube recanalization could allow a high percentage of women with infertility caused by blocked fallopian tubes to conceive with less involved or, in some cases, no further invasive fertility procedures.

“This procedure and treatment can help women make an informed decision about infertility treatments; and for many, it can actually give them the chance to conceive naturally,” commented study investigator Lindsay Machan, MD, in the SIR press release. “As women increasingly desire more thorough discussions of available options and input into their medical care, they appreciate detailed information to help them make choices. This is especially true with fertility treatments.” Dr. Machan is an Associate Professor in the Department of Radiology at the University of British Columbia in Vancouver, Canada.

Dr. Machan advised that the research suggests selective salpingography should be offered more broadly in assessing and treating female infertility. He added, “Fertility treatments can be expensive and out of reach for many women. Infertility is also an emotional, often heart-breaking journey, so having this diagnostic procedure and treatment available could be life-changing.”

The study, “Radiologic Findings in Infertile Women Referred for Selective Salpingography and Fallopian Tube Recanalization,” by Sharma et al will be presented at the SIR 2022 annual scientific meeting held June 11-16 in Boston, Massachusetts.

According to SIR, the investigators from the University of British Columbia Hospital studied cases from 2015 to 2021 involving 956 women with infertility who previously had been diagnosed as having one or both fallopian tubes blocked based on hysterosalpingogram (HSG), the standard procedure used to assess the openness of fallopian tubes.

The women then underwent a diagnostic examination using selective salpingography to confirm their HSG diagnosis and, if needed, underwent fallopian tube recanalization. In many cases, the purported blockage was only a piece of mucus that was easily removed, reported the investigators.

As summarized in the SIR press release, the results with selective salpingography included the following:

• Approximately one in four (23.8%) patients had been mistakenly told they had one or both blocked fallopian tubes.
• More than half (56.7%) of patients with a blockage were unblocked using a fine wire in the fallopian recanalization process.
• 80.5% of women in the study who had previously been told they had tubal blockages left the same day with both fallopian tubes open after an outpatient procedure.
• In an additional 15.9% of patients, a more precise diagnosis of significant tubal disease was made that, in many cases, potentially altered treatment options.

Selective salpingography uses x-ray guidance to insert a tiny catheter through the cervix and into the opening of the fallopian tubes. Contrast dye is then injected to assess whether the tubes are open or blocked. In many cases, the interventional radiologist is then able to perform recanalization, which opens the tube using a fine guidewire. The procedure is performed as an outpatient under light sedation and typically takes less than 30 minutes, noted the SIR press release.