研究開発・学会発表

【発表の概要】

【Objective】Falloposcopic Tuboplasty(FT) has been established as a highly useful, less invasive and novel treatment for women with tubal infertility. The aim of this study was to evaluate the pregnancy outcome with　in patient’s category,such as age, damaged lesion of tubal parts, Chlamydia infection, uterotubal ostium lesion by hysterofiberscopy and folds in the tubal lumen by FT. Another aim was within what　month most pregnancy occurs after successful FT.

【Design】Retrospective study.

【Materials and Methods】A total of 206 women with confirmed bilateral or unilateral occlusion and stenosis were studied. These patients had been diagnosed by hysterosalpingogram at least twice. Patients with hydrosalpinges, male factor and high FSH were excluded from this study. Lesions in the tubal lumen were observed falloposcopically during retrograde imaging after complete cannulation with the linear everting catheter system.

【Results】FT successfully accessed 97% (206/212). There were no operative and postoperative complications. The rate of pregnancy following FT treatment was 34.5% (71/212) over a follow-up period of 4 months to 2 years. Most pregnancy occurred within the 6 months of treatment. Within 71 pregnancy cases, one ectopic pregnancy had occurred. Pregnancy rate didn’t decrease under the age of　40 years. In bilateral tubal stenosis, the level of damaged tubal lumen is connected with the following low pregnancy out comes (7.1%). Both Chlamydia infection and damaged tubal each portion were not related to the pregnancy rate. There was no difference in the pregnancy rate between normal and abnormal findings of uterotubal ostium with hysterofiberscopy.

【Conclusion】This FT technique is useful for the patients with tubal infertility. FT is recommended to the selected patients with tubal infertility below 40 years old before conducting IVF. Patients who had abnormal tubal folds almost allover the tube were observed with lower pregnancy rate following FT. Therefore it is recommended to reconsider the therapeutic plan for these patients at an early stage after FT.