Retrospective Analysis of Fertility following Fallopian Tube Recanalization

Wednesday, April 2, 2025

11:51 AM – 12:00 PM CT

Location: Music City Center, 204

Presenting Author(s)

HB

Harrison S. Blume (he/him/his)

Medical Student
Albert Einstein College of Medicine, United States

Author/Co-author(s)

Christine Yoon (she/her/hers)

Medical Student
Albert Einstein College of Medicine, United States
Zev Hirt

Medical Student
Albert Einstein College of Medicine, United States
KW

Kapil Wattamwar, MD

Interventional Radiology Fellow
Montefiore Medical Center, United States
Jacob Cynamon, MD, FACR, FSIR

Attending
Montefiore Medical Center, United States

Purpose: In the last 20 years, in vitro fertilization (IVF) has experienced rapid advances, with significant focus in both clinical and public discourse. However, there has been comparatively less attention in the literature on Fallopian Tube Recanalization (FTR), despite its continued relevance in managing tubal factor infertility. This study aims to review the effectiveness and outcomes of FTR over the last 10 years at a single institution.

Materials and Methods: This retrospective study analyzed 53 patients who underwent 55 FTR procedures at a single urban academic medical center between April 2015 and July 2024. Patient demographics, including age, obstetric history, and infertility type (primary or secondary), were recorded. Patients with unilateral and bilateral tubal obstruction were included. Post-procedural follow-up was conducted for an average of 20.8 months to assess pregnancy outcomes.

Results: The technical success rate was 90% for unilateral recanalization and 94% for bilateral. 12 (22.6%) patients underwent IVF. The average age at the time of FTR was 37.1 years, with an average age of 36.4 for the FTR-only group (n=41), 38.8 for the FTR after IVF group (n=5) and 39.9 for the FTR before IVF group (n=7). 8 (15%) of patients conceived after FTR, 5 of whom gave birth having an average age of 34.0 at time of FTR. The 3 patients who conceived but did not give birth had an average age of 38.2 at FTR and all underwent IVF with an average age of 36.7. The time between FTR and conception was 11.6 months in the FTR-only group versus 29.6 months in the FTR + IVF group. The average time to initiate IVF after FTR was 30 months and the average time to conception after IVF was 10.29 months. No ectopic pregnancies were reported.

Conclusion: FTR was technically successful in the majority of cases; however, the low conception and live birth rates, particularly among older patients, suggest limited effectiveness. Patients initiated IVF an average of 30 months after FTR and conceived at an older age without live birth. These findings raise concerns that FTR may delay more effective fertility treatments like IVF, particularly for older patients. Future research should focus on identifying optimal candidates for FTR and assessing the long-term impact of delaying IVF. Multi-institutional studies are needed to confirm these trends and better inform clinical decision-making.