Proximal tubal obstruction

Abstract

Proximal tubal blockage is most commonly caused by an inflammatory process such as salpingitis isthmica nodosa, endometriosis, and surgical trauma such as post-myomectomy. Tubal disease is one of the most common diagnoses for IVF and upon diagnosis, IVF is most often recommended. However, many women decide not to proceed with IVF due to the cost, or religious reasons. Fallopian tube cannulation either with hysteroscopy/laparoscopy or under fluoroscopy at the time of HSG can be performed with patency rates of 70-80 percent but the pregnancy rates remain low. This chapter reviews the causes of proximal tubal blockage, diagnosis, treatment, and success rates.