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Fallopian Tube Reconstruction Workup

  • Author: Krystene B DiPaola, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
 
Updated: May 13, 2014
 

Laboratory Studies

Male factors

See the list below:

  • Men account for 30-40% of infertility in couples.
  • Problems typically include low semen volume, decreased sperm concentration and/or motility, and abnormal sperm morphology.
  • Semen analysis is necessary.

Female factors

In some women, ovulatory problems are a cause of infertility. Ovulatory function tests can help determine ovulatory function. Adequate ovulatory function can be confirmed with the following:

  • Normal regular menstrual cycles
  • Day 3 follicle-stimulating hormone level within the reference range
  • Anti-mullerian hormone level
  • Midluteal-phase serum progesterone measurement confirmatory of ovulation

Papanicolaou test (Pap smear) results must be normal.

Cervical culture results (eg, C trachomatis, N gonorrhea) must be negative.

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Imaging Studies

Hysterosalpingography may be used to determine the presence of proximal fallopian tubes.

When necessary, saline sonography further defines abnormalities of the uterine cavity.

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Other Tests

Basal body temperature charting can help identify female ovulatory factors.

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Diagnostic Procedures

Laparoscopy

  • This procedure helps to (1) evaluate the amount of pelvic adhesions and tubal damage before tubal reconstructive surgery; (2) measure the diameter of a hydrosalpinx to determine the feasibility of tubal reconstruction; and (3) identity the distal portion of the fallopian tube(s) prior to tubal anastomosis following sterilization procedures.
  • This procedure also facilitates estimation of the length of the tube resulting from the tubal reconstructive surgery.
  • Tubal and pelvic reconstruction can be performed with the patient under the same anesthesia following diagnostic laparoscopy, via operative laparoscopy, or via laparotomy when necessary. However, patients may request a different surgical procedure on a different day if a laparotomy is required.

Timed endometrial biopsy can help identify female ovulatory factors.

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Contributor Information and Disclosures
Author

Krystene B DiPaola, MD Medical Director, Assistant Professor, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Cincinnati College of Medicine

Krystene B DiPaola, MD is a member of the following medical societies: American Medical Association, American Society for Reproductive Medicine, Sigma Xi, Society for Assisted Reproductive Technology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christine Isaacs, MD Associate Professor, Department of Obstetrics and Gynecology, Division Head, General Obstetrics and Gynecology, Medical Director of Midwifery Services, Virginia Commonwealth University School of Medicine

Christine Isaacs, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists

Disclosure: Nothing to disclose.

Chief Editor

Richard Scott Lucidi, MD, FACOG Associate Professor of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine

Richard Scott Lucidi, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Suzanne R Trupin, MD, FACOG Clinical Professor, Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Urbana-Champaign; CEO and Owner, Women's Health Practice; CEO and Owner, Hada Cosmetic Medicine and Midwest Surgical Center

Suzanne R Trupin, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, International Society for Clinical Densitometry, AAGL, North American Menopause Society, American Medical Association, Association of Reproductive Health Professionals

Disclosure: Nothing to disclose.

References
  1. Centers for Disease Control and Prevention. 2005 Assisted Reproductive Technology (ART) Report. Available at http://www.cdc.gov/ART/ART2005/index.htm. Accessed: September 5, 2008.

  2. ART 2006: Assisted Reproductive Technology (ART) Report: Home. Available at http://www.cdc.gov/ART/ART2006/index.htm.

  3. ASRM Guidelines on numbers of embryos transferred. [Full Text].

  4. Practice Committee of the American Society for Reproductive Medicine. The role of tubal reconstructive surgery in the era of assisted reproductive technologies. Fertil Steril. 2006 Nov. 86(5 Suppl):S31-4. [Medline].

  5. Apodaca CC, Gililland JL. Successful repeat microsurgical fallopian tube anastomosis. A case report. J Reprod Med. 1995 May. 40(5):407-8. [Medline].

  6. Degueldre M, Vandromme J, Huong PT, Cadière GB. Robotically assisted laparoscopic microsurgical tubal reanastomosis: a feasibility study. Fertil Steril. 2000 Nov. 74(5):1020-3. [Medline].

  7. Detweiler MB, Detweiler JG, Fenton J. Sutureless and reduced suture anastomosis of hollow vessels with fibrin glue: a review. J Invest Surg. 1999 Sep-Oct. 12(5):245-62. [Medline].

  8. Dubuisson JB, Aubriot FX, Henrion R. [Microsurgical desterilizations. Reflections on 65 cases]. J Gynecol Obstet Biol Reprod (Paris). 1986. 15(2):223-9. [Medline].

  9. Dubuisson JB, Chapron C, Nos C, et al. Sterilization reversal: fertility results. Hum Reprod. 1995 May. 10(5):1145-51. [Medline].

  10. Eytan O, Azem F, Gull I, Wolman I, Elad D, Jaffa AJ. The mechanism of hydrosalpinx in embryo implantation. Hum Reprod. 2001 Dec. 16(12):2662-7. [Medline].

  11. Falcone T, Goldberg JM, Margossian H, Stevens L. Robotic-assisted laparoscopic microsurgical tubal anastomosis: a human pilot study. Fertil Steril. 2000 May. 73(5):1040-2. [Medline].

  12. Feinberg EC, Levens ED, DeCherney AH. Infertility surgery is dead: only the obituary remains?. Fertil Steril. 2008 Jan. 89(1):232-6. [Medline].

  13. Gan SX. [Pathological observations on fallopian tubes after sterilization]. Zhonghua Fu Chan Ke Za Zhi. 1991 Mar. 26(2):103-5, 125. [Medline].

  14. Gauwerky JF. [Endoscopic sterilization reversal]. Zentralbl Gynakol. 1991. 113(15-16):865-8. [Medline].

  15. Glock JL, Kim AH, Hulka JF, et al. Reproductive outcome after tubal reversal in women 40 years of age or older. Fertil Steril. 1996 Apr. 65(4):863-5. [Medline].

  16. Gomel V. Microsurgical reversal of female sterilization: a reappraisal. Fertil Steril. 1980 Jun. 33(6):587-97. [Medline].

  17. Gomel V. Reversal of tubal sterilization versus IVF in the era of assisted reproductive technology: a clinical dilemma. Reprod Biomed Online. 2007 Oct. 15(4):403-7. [Medline].

  18. Gomel V. Tubal reanastomosis by microsurgery. Fertil Steril. 1977 Jan. 28(1):59-65. [Medline].

  19. Henry A, Rinehart W, Piotrow PT. Reversing female sterilization. Popul Rep C. 1980 Sep. C97-123. [Medline].

  20. Honore GM, Holden AE, Schenken RS. Pathophysiology and management of proximal tubal blockage. Fertil Steril. 1999 May. 71(5):785-95. [Medline].

  21. Hurst BS, Thomsen S, Lawes K, Ryan T. Controlled radiofrequency endotubal sterilization. Adv Contracept. 1998 Jun. 14(2):147-52. [Medline].

  22. Jenkins CS, Williams SR, Schmidt GE. Salpingitis isthmica nodosa: a review of the literature, discussion of clinical significance, and consideration of patient management. Fertil Steril. 1993 Oct. 60(4):599-607. [Medline].

  23. Jiang ZM, Luo TX, Zheng HG, et al. [Ultrastructural study of fallopian tubes after occlusive sterilization with phenol-mucilage]. Shengzhi Yu Biyun. 1991 Nov. 11(4):35-8. [Medline].

  24. Kim JD, Kim KS, Doo JK, Rhyeu CH. A report on 387 cases of microsurgical tubal reversals. Fertil Steril. 1997 Nov. 68(5):875-80. [Medline].

  25. Kim SH, Shin CJ, Kim JG, Moon SY, Lee JY, Chang YS. Microsurgical reversal of tubal sterilization: a report on 1,118 cases. Fertil Steril. 1997 Nov. 68(5):865-70. [Medline].

  26. Koh CH, Janik GM. Laparoscopic microsurgical tubal anastomosis. Adamson GD, ed. Endoscopic Management of Gynecological Disease. Philadelphia, Pa: Lippincott-Raven; 1996. 119-45.

  27. Koh CH, Janik GM. Laparoscopic microsurgical tubal anastomosis. Obstet Gynecol Clin North Am. 1999 Mar. 26(1):189-200, viii. [Medline].

  28. Lang EK. The efficacy of transcervical recanalization of obstructed postoperative fallopian tubes. Eur Radiol. 1998. 8(3):461-5. [Medline].

  29. Li MS. [A clinical analysis of 317 cases of salpingo-anastomoses]. Zhonghua Fu Chan Ke Za Zhi. 1991 May. 26(3):166-8, 188-9. [Medline].

  30. Margolis MT, Thoen LD, Wheeless CR Jr, Mercer LJ. Rabbit fallopian tube reanastomosis using a microvascular stapling device. J Gynecol Surg. 1995. 11(2):79-83. [Medline].

  31. Mettler L, Ibrahim M, Lehmann-Willenbrock E, Schmutzler A. Pelviscopic reversal of tubal sterilization with the one- to two-stitch technique. J Am Assoc Gynecol Laparosc. 2001 Aug. 8(3):353-8. [Medline].

  32. Owen ER, Pickett-Heaps AA. The microsurgical basis of Fallopian tube reconstruction. Aust N Z J Surg. 1977 Jun. 47(3):300-5. [Medline].

  33. Posaci C, Camus M, Osmanagaoglu K, Devroey P. Tubal surgery in the era of assisted reproductive technology: clinical options. Hum Reprod. 1999 Sep. 14 Suppl 1:120-36. [Medline].

  34. Putman JM, Holden AE, Olive DL. Pregnancy rates following tubal anastomosis: Pomeroy partial salpingectomy versus electrocautery. J Gynecol Surg. 1990 Fall. 6(3):173-8. [Medline].

  35. Reich H, McGlynn F, Parente C, et al. Laparoscopic tubal anastomosis. J Am Assoc Gynecol Laparosc. 1993 Nov. 1(1):16-9. [Medline].

  36. Rouzi AA, Mackinnon M, McComb PF. Predictors of success of reversal of sterilization. Fertil Steril. 1995 Jul. 64(1):29-36. [Medline].

  37. Sacks G, Trew G. Reconstruction, destruction and IVF: dilemmas in the art of tubal surgery. BJOG. 2004 Nov. 111(11):1174-81. [Medline].

  38. Shen Y, Xue P. [Morphological observation of mucosal epithelium after tubal sterilization]. Shengzhi Yu Biyun. 1992 Jun. 12(3):23-8. [Medline].

  39. Silber SJ, Cohen R. Microsurgical reversal of female sterilization: the role of tubal length. Fertil Steril. 1980 Jun. 33(6):598-601. [Medline].

  40. Silva PD, Perkins HE. Improved combined laparoscopic and minilaparotomy technique to allow for reversal of extensive tubal sterilization. J Am Assoc Gynecol Laparosc. 1995 May. 2(3):327-30.

  41. Speroff L, Glass RH, Kase NG. Female infertility. Speroff L, Glass RH, Kase NG, eds. Clinical Gynecologic Endocrinology and Infertility. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999. 1013-42.

  42. Strandell A, Waldenstrom U, Nilsson L, Hamberger L. Hydrosalpinx reduces in-vitro fertilization/embryo transfer pregnancy rates. Hum Reprod. 1994 May. 9(5):861-3.

  43. Swolin K. [50 fertility operations. I. Literature and methods]. Acta Obstet Gynecol Scand. 1967. 46(2):234-50. [Medline].

  44. Tortoriello DV, McGovern PG, Colon JM, et al. Critical ovarian hyperstimulation syndrome in a coasted in-vitro fertilization patient. Hum Reprod. 1998 Nov. 13(11):3005-8. [Medline].

  45. Tran DK. Microsurgical tubal reanastomosis. J Gynecol Obstet Biol Reprod (Paris). 1986. 15 Suppl:103-4.

  46. Van Voorhis BJ. Comparison of tubal ligation reversal procedures. Clin Obstet Gynecol. 2000 Sep. 43(3):641-9. [Medline].

  47. Vandromme J, Chasse E, Lejeune B, et al. Hydrosalpinges in in-vitro fertilization: an unfavourable prognostic feature. Hum Reprod. 1995 Mar. 10(3):576-9.

  48. Wang X, Bilolo KK, Qi S, et al. Restoration of fertility in oophorectomized rats after tubo-ovarian transplantation. Microsurgery. 2002. 22(1):30-3. [Medline].

  49. Wang YH. [Microsurgical technique of tubal reconstruction after surgical sterilization: a report of 40 cases]. Shengzhi Yu Biyun. 1988 Nov. 8(4):19-22. [Medline].

  50. Winston RM. Microsurgical tubocornual anastomosis for reversal of sterilisation. Lancet. 1977 Feb 5. 1(8006):284-5. [Medline].

  51. Yoon TK, Sung HR, Cha SH, Lee CN, Cha KY. Fertility outcome after laparoscopic microsurgical tubal anastomosis. Fertil Steril. 1997 Jan. 67(1):18-22. [Medline].

  52. Yossry M, Aboulghar M, D'Angelo A, Gillett W. In vitro fertilisation versus tubal reanastomosis (sterilisation reversal) for subfertility after tubal sterilisation. Cochrane Database Syst Rev. 2006 Jul 19. 3:CD004144. [Medline].

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Sites and frequencies of ectopic pregnancy. By Donna M. Peretin, RN. (A) Ampullary, 80%; (B) Isthmic, 12%; (C) Fimbrial, 5%; (D) Cornual/Interstitial, 2%; (E) Abdominal, 1.4%; (F) Ovarian, 0.2%; (G) Cervical, 0.2%.
Salpingitis isthmica nodosa. Image courtesy of Jairo E. Garcia, MD.
Hydrosalpinx. Image courtesy of Jairo E. Garcia, MD.
 
 
 
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