Millions of women seek professional treatment of infertility treatment of infertility. Infertility is defined as the inability to conceive after 12 months of unprotected intercourse. There are male and female factors that can be the culprit. The most common of the female factors are caused by blockages in one or both of the fallopian tubes accounting for ~40% of cases.
A blockage in the fallopian tube can occur in the beginning (uterine end) or the distal end (ovarian end) of the tube (or rarely both). A blockage at the beginning of the tube is more common and is due to a mucus plug which blocks the opening of the tube and causes infertility. A distal (ovarian end) blockage is due to adhesions (inflammatory process) from a previous surgery or previous pelvic infection. These adhesions are like sticky rubber bands on the outside of the tube and pinch it closed from the outside. The treatment of distal blockages needs to be handled with laparoscopic surgery. Therefore, for distal tubal blockages, the adhesions which may have resulted from surgery can only be corrected with more surgery which ultimately can lead to more adhesions.
However, the much more common proximal (uterine end) blockages are on the inside of the tube. These blockages are similar to a clog in your bathroom sink. This type of blockage can be unclogged from the inside with tools that are used routinely by Interventional Radiologists. This mechanical unblocking procedure is called Transcervical Fallopian Tubal Recanalization (TFTR). Dr Lipman has been performing this procedure for over 25 years and has one of the nation’s largest TFTR experience. The procedure is performed as an outpatient under light (conscious) sedation. Patients are discharged within 1 hour from the procedure and return to work the following day. Patients who thought their only option was adoption or the much more expensive (40-50X more) In Vitro Fertilization (IVF) procedure have found success with the much simpler, less invasive TFTR procedure. Pregnancy rates following TFTR are equivalent to slightly better than IVF.
Transcervical Fallopian Tubal Recanalization: What to Expect From the Procedure
The TFTR exam begins with an evaluation of the uterine cavity and to check to see if the fallopian tubes are open or blocked. This procedure is called a Hysterosalpingogram (HSG). A thin (thinner than a pencil) catheter is advanced into the cervical opening and advanced in to the uterine cavity. A liquid contrast agent is injected under x-ray which is visible on the television screens adjacent to the patient. The cavity of the uterus will fill first and typically is triangular in appearance with straight sharp margins. The catheter is seen at the bottom point of the triangle and each fallopian tube is typically seen at the other 2 points of the triangle. The ovarian end of the tube is open to the pelvic cavity. Therefore, contrast should “spill” freely in to the pelvis which will be resorbed by the body and excreted in the patient’s urine.
If either (or both) of the tubes are blocked, the patient will feel discomfort and/or pain during the injection of contrast. Unlike most Centers that perform this procedure, the Atlanta Fibroid CenterAtlanta Fibroid Center will place an intravenous line in the patient’s arm prior to the procedure so that the patient is perfectly comfortable during the HSG and/or TFTR examination.
What Is the Probability of Success?
In 40-50% of cases, patients have conceived within 6 months after the procedure. If the pregnancy has not occurred, it is recommended to repeat the procedure after 6 months. This is because some women reform the plug before conceiving and have been recanalized with subsequent pregnancy following the second TFTR.
Transcervical Fallopian Tubal Recanalization is dramatically cheaper than IVF, spares women the numerous office visits, hormone shots, and ultrasounds that accompany IVF. It also allows women to conceive and bear children the natural way. There is also a much lower chance of multiple gestations which can cause undue anxiety in women who were not prepared for having to consider multifetal pregnancy reduction.
To learn more about female infertility and Transcervical Fallopian Tubal Recanalization (TFTR), call the Atlanta Fibroid Center at 770-953-2600 or make an appointment online.