Fallopian Tube Recanalization

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Fallopian Tube Recanalization (FTR) is a minimally invasive procedure that can reopen certain blocked fallopian tubes, particularly blockages near the uterus. FTR is performed through the cervix using fluoroscopic X-ray guidance and does not require abdominal surgery.

The fallopian tubes provide the pathway for an egg and sperm to meet and allow a fertilized egg to travel toward the uterus. A blockage in a fallopian tube can interfere with natural conception.

FTR uses a small catheter and, when necessary, a very small guidewire to access and reopen a blocked portion of the fallopian tube.

FTR is most commonly used to treat proximal tubal obstruction, meaning a blockage in the portion of the tube closest to the uterus.

FTR is performed as an office procedure and typically takes less than 20 minutes.

1. HSG evaluation: An HSG is performed to evaluate the uterus and fallopian tubes. If a proximal blockage is identified, additional imaging may be performed to determine whether the tube can be successfully accessed.
2. Catheter placement: A small catheter is placed through the cervix and into the uterus.
3. Recanalization: If the tube remains blocked, a smaller catheter and/or guidewire is gently advanced into the opening of the fallopian tube to cross the obstruction.
4. Confirmation: Contrast is injected to confirm whether the tube has been reopened and whether contrast passes through the tube into the pelvic cavity.

No abdominal incision or stitches are required.

FTR may be appropriate for patients with proximal fallopian tube obstruction identified on HSG or other imaging.

FTR can successfully restore patency in many patients with proximal tubal obstruction. The likelihood of successful recanalization depends on the location and extent of the obstruction and the condition of the fallopian tube.

FTR may be particularly useful when the obstruction is limited to the proximal portion of the tube and there is no evidence of significant distal tubal disease.

FTR is generally intended for proximal tubal obstruction. It is less suitable for significant distal tubal disease, extensive scarring, or other conditions in which the fallopian tube is unlikely to function normally even if it can be reopened.

Your HSG findings and overall fertility history help determine whether FTR is a reasonable option.

FTR is performed without an abdominal incision. Most patients remain awake during the procedure.

You may experience cramping or pressure as the catheter is positioned and as contrast is injected. If additional treatment is needed to reopen the tube, you may feel a brief increase in cramping.

The procedure typically takes less than 20 minutes.

Most patients can return to their usual activities shortly after the procedure.

Your physician will discuss when you can resume trying to conceive and whether any additional fertility treatment or follow-up is recommended.

Reopening a fallopian tube does not guarantee pregnancy. Pregnancy also depends on other factors, including age, ovulation, sperm quality, the condition of the remainder of the fallopian tube, and other fertility factors.

FTR can successfully restore patency in many patients with proximal tubal obstruction. Published studies have reported a range of technical success and pregnancy rates, reflecting differences in patient populations and the underlying cause and location of tubal obstruction.

The likelihood of pregnancy after FTR depends on more than whether the tube can be reopened. The condition of the fallopian tube and other fertility factors are also important.

FTR is generally well tolerated, but, like any medical procedure, it has potential risks:

Cramping or discomfort: Temporary cramping may occur during or after the procedure.

Light bleeding or spotting: Mild bleeding or spotting may occur following the procedure.

Infection: Infection following FTR is uncommon.

Contrast reaction: Allergic reactions to iodinated contrast material are uncommon but possible. Please tell us if you have previously experienced an allergic reaction to iodinated contrast.

Tubal perforation: Rarely, the catheter or guidewire can create a small opening in the fallopian tube. Most cases can be managed without surgery.

Re-occlusion: A fallopian tube that has been successfully reopened may become blocked again.

Ectopic pregnancy: An ectopic pregnancy is possible after FTR. If you become pregnant following the procedure, early evaluation is recommended to confirm that the pregnancy is developing within the uterus.

FTR offers a minimally invasive alternative to surgical treatment for selected proximal tubal blockages.

Unlike laparoscopic surgery, FTR is performed through the cervix using fluoroscopic guidance and does not require an abdominal incision. It may allow appropriately selected patients to pursue natural conception without surgical treatment of the tube.

FTR is not a substitute for surgery or IVF in every situation. The appropriate treatment depends on the location and extent of the tubal obstruction and your overall fertility evaluation.

If your HSG shows a blocked fallopian tube, FTR may be an option if the blockage is located near the uterus and the fallopian tube appears suitable for treatment.

If you have been told that you have a blocked fallopian tube and would like to learn whether FTR may be appropriate, please contact our office.