Hysterosalpingography with selective salpingography.

Objective: To evaluate the use of selective salpingography to achieve tubal patency in patients with proximal fallopian tube occlusion on hysterosalpingography (HSG).

Study Design: We performed a retrospective cohort study on 116 infertile women (age 37.7 +/- 4.6 years) with proximal tubal obstruction treated with selective salpingography. Success was defined as opening at least 1 fallopian tube. Pregnancy was defined as having a positive beta-hCG level.

Results: A total of 151 tubes were blocked on HSG before tubal catheterization; 103 tubes were opened by selective salpingography. Of 116 patients, 84 (72.4%) had successful procedures with at least 1 tube opened by catheterization. Of the 116, 32 (27.6%) had failed procedures with no tubes opened. Of 83 patients, 30 (36.1%) with successful procedures achieved pregnancy. Of these pregnancies, 16 occurred spontaneously or following ovulation induction and 5 pregnancies occurred in the failure group, allfollowing in vitro fertilization.

Conclusion: Selective salpingography is useful in demonstrating tubal patency, reducing the diagnosis of tubal disease and potentially minimizing surgery in infertile patients.