As an interventional radiologist, Dr. Lipman can remove blockages within the fallopian tubes using a radiological imaging system in concert with specialized instruments. In roughly 90% of such cases, he will be able to clear a blockage, often restoring fertility. Patients interested in considering this procedure should make an appointment with Dr. Lipman in order to discuss the viability of the procedure based on the patient’s health history and current condition.
What is Infertility?
Infertility is defined as the inability to conceive after 1 year of unprotected intercourse. Approximately 15-20% of couples in the United States have some form of infertility, and the most common factor involves a blockage of the fallopian tubes. Unfortunately due to a lack of awareness, many of the patients with tubal blockage are referred for the more expensive and intensive in-vitro fertilization (IVF) procedure. Dr. Lipman takes a much simpler approach that removes the blockage to women’s fallopian tubes. Once the fallopian tubes have been cleared, couples can then attempt pregnancy naturally.
How do I know if my tubes are blocked?
Blockage of the fallopian tubes is diagnosed by a x-ray study called Hysterosalpingography (HSG). It involves injecting contrast (dye) in to the uterine cavity to see if the fallopian tubes are open or blocked.
What is causing the blockage?
The blockage is caused by an adherent plug of mucus that forms over the opening of the fallopian tube(s). In some women, injecting the contrast for the HSG will dislodge the plug with immediate opacification of both of the tubes. Therefore, for some women they only need the HSG to open their tubes.
If one or both of the tubes remain blocked after the HSG, we can then immediately proceed with a simple, inexpensive procedure called Transcervical Fallopian Tubal Recanalization (TFTR).
How does TFTR work?
TFTR is performed under light intravenous sedation and takes approximately 30 minutes. A tiny catheter and guidewire are used to mechanically dislodge the plug from the opening (similar to unblocking a clog in a drainpipe).
What are the benefits to TFTR?
1. Simplicity: Easy procedure for patient to undergo with high patient satisfaction.
2. Inexpensive: Much less expensive than IVF.
3. Successful: Pregnancy rates equal to or superior to IVF.
4. No hormones: Un-blocking the tubes without hormones (unlike IVF).
5. No general anesthesia: Performed under light (intravenous) sedation.
6. Rapid recovery: Immediate return to regular activity and work.
7. Some insurance coverage
What is transcervical fallopian tubal recanalization (TFTR)?
TFTR is performed under light sedation and takes approximately 30 minutes. There is a brief recovery period (less than one hour) and the patient can resume regular activities immediately. We are typically able to open up both fallopian tubes which results in a relatively high clinical success rate (up to 60% pregnancy rate). This success rate is equivalent to or higher than in-vitro fertilization.
What do I need to do if I get pregnant after a TFTR?
If you get pregnant after a TFTR procedure, you will need to confirm your pregnancy with a pelvic ultrasound.
Will the mucus plug(s) form again after a period of time?
Yes, it is possible that the mucus plug(s) will re-form, but the hope is that by the time plug(s) re-form, you are already pregnant.
If women who undergo TFTR do not become pregnant by 6 months after the procedure we recommend they return for a follow-up Hysterosalpingogram (HSG).
In half of these women, we will see on HSG that their tubes are still open from when we un-blocked them 6 months earlier. For these women, the Ob/Gyn will focus on the hormonal/ovarian things that have to be optimized to be pregnant.
For the remaining women, the HSG shows that a mucus plug has re-formed. We then proceed to un-block these patients one additional time, because a number of women become pregnant after the second recanalization.