ABSTRACT
Selective salpingography using specialized catheters under fluoroscopy has become increasingly popular for both tubal sterilization and the evaluation of tubal patency and pathophysiology. Transcervical tubal cannulation by hysteroscopic, fluoroscopic, and ultrasonographic methods are presently the most minimally invasive options for patients with infertility and proximal tubal occlusion. Approximately 20-50% of female infertility is associated with tubal obstruction, of which 20% is due to proximal disease. In the past, these patients were treated with extensive reconstructive surgery involving uterotubal implantation. Subsequent tubal patency rates ranged from 30-50% utilizing macrosurgical technique; however, the term delivery rate was unacceptably low. In 1977, microsurgical anastomosis was described. Prior to Assisted Reproductive Technologies (ART), it had been considered the gold standard for the surgical treatment of proximal tubal occlusion, yielding significantly higher, yet unreliable, term pregnancy rates. Consequently, the wide range of suc cess with surgical interventions, compounded by the high cost of ART, mandated the need for accessible yet less invasive technologies.
