277 - Fallopian Tube Recanalization: A First-Line Alternative to IVF for Tubal Factor Infertility

Tuesday, April 14, 2026

3:18 PM - 3:27 PM ET

Presenting Author(s)

MT

Michelle Trang, BS

Medical Student
UTMB John Sealy School of Medicine Galveston, United States

Author/Co-author(s)

VT

Victoria Teoh, BA

Medical Student
UTMB John Sealy School of Medicine Galveston, United States
CM

Chiedza Mutindori, BS

Medical Student
UTMB John Sealy School of Medicine Galveston, United States
AS

Arsalan Saleem, MD

Program Director
UTMB Galveston, Diagnostic & Interventional Radiology, United States

Purpose: Fallopian Tube Recanalization (FTR) is a minimally invasive hysteroscopy-guided outpatient procedure that has demonstrated high technical success {1}. Previous studies have reported comparable outcomes for FTR and IVF; however, only IVF has increased in popularity and utilization. Current literature lacks direct outcome comparisons between the two treatments. We aim to illuminate FTR as a comparable, alternative initial step in addressing infertility for patients with tubal obstruction before escalation to IVF when appropriate.

Materials and Methods: A retrospective cohort study was conducted using the TriNetX Research Network. Deidentified information for female patients >18 and < 40 years of age with the diagnosis of tubal infertility (N97.1) were used. Two cohorts were created: Cohort 1 (n=868) included patients with IVF procedures (S4011, 1008937), Cohort 2 (n=1065) included patients with FTR (58345). Both cohorts only included the first instance of either IVF or FTR. Propensity score matching (PSM) was done for age, race, ethnicity, endometriosis, PCOS, BMI, pelvic inflammatory disease, diabetes mellitus, hyperthyroidism, and hypothyroidism. Comparison after PSM (n=652) was done, exploring outcomes of high-risk pregnancy and pregnancy resulting in full-term delivery (FTD) within 18 months of treatment. Risk difference (RD) with 95% confidence interval (95% CI) was used as a measure of association between FTR and IVF outcomes, with p value < 0.05 demonstrating significant cohort outcome differences.

Results: In our final cohort of 1304 patients with tubal factor infertility, 35 patients had FTD after FTR, while 35 patients had FTD following IVF. Our results show similar live birth rates (RD, -1.38; 95% CI, -3.97-1.21; p=0.30) with no significant increase in high risk-pregnancies (RD, 1.47; 95% CI, -3.41-6.35; p=0.55) between cohorts. These results are consistent with our literature review findings and demonstrate that FTR yields comparable outcomes to IVF.

Conclusion: FTR is a valuable infertility treatment with substantial clinical and economic advantages that should be considered a first-line treatment option in appropriate candidates. IVF can be considered as a next-step option. Further research should investigate reasons for FTR underutilization by illuminating referral patterns, treatment trends, and billing motives. Additionally, conducting a multicenter prospective study can strengthen generalizability and address confounding variables, while educational efforts towards patient and clinician awareness can support increased utilization.