The Effect of FallopianTubal Perfusion Pressure Reduction during Selective Salpingography in Assessing Tubal Status and Fertility Potential
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BACKGROUND: The value of tubal perfusion pressures assessment during selective salpingography and tubal catheterization in predicting fertility in patients with tubal obstruction has not been investigated. PURPOSE: To clarify the issue of reducing the high fallopian tubal perfusion pressure with the use of fluoroscopically guided selective salpingography and tubal catheterization in improving fertility prognosis. PATIENTS & METHODS: A total o144 infertile women with fallopian tubal obstruction underwent selective salpingography and tuba! catheterization. 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, mediocre and poor. Complete pregnancy and tubal perfusion pressure data were collected and could be followed up to 56 months for only 20 patients of the poor group. RESULTS: Following tubal catheterization, 6 women (group A) could be classified in the good, 4 (group B) in the mediocre, while 10 (group C) remained in the poor tubal perfusion pressure group. The pregnancy rate in the good perfusion pressure group was significantly higher than that in the mediocre or poor perfusion pressure groups, (P = 0.035 and 0.011 respectively). The pregnancy rate was similar in either the mediocre or poor groups, though none of the comparisons reached statistical significance. CONCLUSION: Selective salpingography can provide additional diagnostic information in comparison with other tubal assessment tests. Reduction of tubal perfusion pressure will be beneficial treatment to successful conception of these infertile women.