Fallopian Tube Recanalization

Fallopian Tube Recanalization (FTR) is a minimally invasive image-guided procedure performed by an interventional radiologist to open a blocked fallopian tube. It is mainly used in women who have infertility caused by a blockage near the uterus (proximal tubal blockage).

Instead of surgery, a very thin catheter and guidewire are used to gently clear the blockage, allowing the egg and sperm to meet naturally.

What are the Fallopian Tubes?

-The fallopian tubes are two thin tubes connecting the uterus to the ovaries.

Their functions are:

  • Pick up the egg after ovulation
  • Allow fertilization by sperm
  • Transport the fertilized egg to the uterus

If one or both tubes are blocked, pregnancy may become difficult.

Causes of Fallopian Tube Blockage

Common causes include:

  • Pelvic Inflammatory disease (PID)
  • Previous pelvic infection
  • Endometriosis
  • Previous pelvic surgery
  • Previous ectopic pregnancy
  • Tuberculosis (in some countries)
  • Mucus plugs
  • Tubal spasm
  • Adhesions (Minor scar tissue)
  • Congenital b
  • irth anomalies 

Who Needs Fallopian Tube Recanalization?

The procedure may be recommended if:

  • Difficulty becoming pregnant for over one year
  • HSG shows blockage near the uterus
  • Normal uterus and ovaries
  • Partner’s semen analysis is normal
  • No severe distal tubal disease

Who Should Not Undergo FTR?

It is usually not recommended if:

  • Active pelvic infection
  • Pregnancy
  • Complete destruction of the tube
  • Severe distal tubal blockage
  • Hydrosalpinx
  • Tubal cancer (rare)

Symptoms of Tubal Blockage:

Many women have no symptoms.

Some may experience:

  • Infertility
  • Chronic pelvic pain
  • Painful periods
  • Previous pelvic infection
  • Previous ectopic pregnancy

Preparation Before the Procedure:

The patient may be advised to:

  • Fast for a few hours (if sedation is planned)
  • Stop blood thinners if taking 3 days prior 
  • Take prescribed antibiotics if advised
  • Empty the bladder
  • Avoid intercourse before the procedure if instructed
  • Sign informed consent

Pre Procedure Evaluation:

1. Clinical Assessment

The doctor reviews:

  • Medical history
  • Infertility history
  • Menstrual history
  • Previous pregnancies
  • Previous miscarriages
  • Previous pelvic infections
  • Previous surgeries
  • Current medications
  • Allergies

2. Blood Tests

  • Complete Blood Count (CBC)- WBCs, RBCs, Platelet- To rule out anemia and any signs of infection 
  • Blood sugar (if required)
  • Coagulation profile (PT/INR)- to know body’s ability to clot, helping reduce the risk of bleeding 

3. Imaging Tests

Common investigations include:

  • Hysterosalpingography (HSG)- Main test to identify the location and extent of ubal blockage
  • Pelvic ultrasound– To asses the uterus, ovaries, cervix and surrounding pelvic structures for any abnormalities.
  • Sometimes MRI or laparoscopy (if needed)- may be recommended if additional information is needed or if other pelvic conditions, such as endometriosis or severe adhesions, are suspected.

Procedure of Fallopian Tube Recanalization:

Step 1: Patient Positioning

-The patient lies comfortably on the X-ray table in the lithotomy position. Vital signs are monitored throughout the procedure.

 

Step 2: Sterile Preparation

-The genital area is cleaned with an antiseptic solution, and sterile drapes are placed to reduce the risk of infection.

 

Step 3: Speculum Placement

-A speculum is gently inserted into the vagina to visualize the cervix.

 

Step 4: Catheter Placement

-A small catheter is inserted through the cervix into the uterus.

 

Step 5: Contrast Injection

Contrast dye is injected while fluoroscopy is used to identify the site of tubal blockage.

 

Step 6: Guidewire Passage

-A very thin guidewire is carefully advanced through the blocked portion of the fallopian tube.

 

Step 7: Tube Recanalization

-A microcatheter is passed over the guidewire to gently open the blocked tube.

 

Step 8: Confirmation

-More contrast dye is injected. Free flow of dye into the abdominal cavity confirms that the tube has been successfully opened.

 

Step 9: Completion

-The catheter and guidewire are removed, and the patient is observed briefly before discharge.

Benefits:

  • No surgical incision
  • Minimally invasive
  • Quick recovery
  • Same-day discharge
  • Can improve natural fertility
  • May avoid surgery
  • High technical success for proximal blockages

Risks and Complications:

Although uncommon, possible complications include:

  • Mild pain or cramping
  • Light vaginal bleeding
  • Infection
  • Allergic reaction to contrast dye
  • Tubal perforation
  • Failure to open the blockage
  • Radiation exposure (very low)

After the Procedure:

Most patients:

  • Rest for a few hours
  • Go home the same day
  • Resume light activities within 24 hours
  • May have mild cramping or spotting for 1–2 days

Post-Procedure Instructions:

  • Drink plenty of fluids
  • Take prescribed medicines
  • Maintain good hygiene
  • Avoid intercourse for a short period if advised
  • Attend follow-up appointments
  • Contact your doctor if you develop severe pain, fever, heavy bleeding, or foul-smelling vaginal discharge

Follow-Up

-The doctor may advise:

  • Follow-up clinic visit
  • Fertility planning
  • Repeat HSG if needed
  • Consultation with a fertility specialist if pregnancy does not occur

Advantages

  • Minimally invasive
  • Outpatient procedure
  • No surgical incision
  • Quick recovery
  • Preserves the fallopian tube
  • Can improve natural fertility
  • May improve the chance of natural conception
  • High technical success for proximal blockages

Limitations

  • Not effective for severe distal tubal disease
  • Some blockages may recur
  • Pregnancy is not guaranteed
  • Other infertility factors may still need treatment

Would you like to request an appointment?

You can call on +91-98200 86520 for Appointments or fill the form below

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