Fluoroscopic tubal recanalization in tubal factor related infertility

Infertility is defined as the inability to conceive after 1 year of unprotected intercourse, a definition that is based on a monthly fecundity rate of 15 to 25%. Approximately 10 to 20% of couples may experience problems conceiving, and infertility can result from a wide variety of etiologies. Female factors account for 40% of infertility.1 When investigating infertility, evaluation of both the male and female partner is warranted, as the likelihood of both partners having impaired fertility is relatively high.1 Dysfunction of the female reproductive process can occur at any of the following steps to cause infertility: 1. Ovarian factor: the ovaries need to produce a mature oocyte. 2. Cervical factor: the cervix needs to capture and transport sperm into the uterus and fallopian tubes. 3. Uterine factor: the uterus needs to allow the embryo to implant. 4. Tubal factor: the fallopian tubes need to capture the ovulated oocyte and transport sperm and embryo. Tubal factor fertility accounts for the most common cause of female infertility (Fig. 1). Tubal adhesive or occlusive disease and peritoneal adhesions are typically due to either prior pelvic inflammatory disease or endometriosis. Another less common cause of proximal tubal occlusion is salpingitis isthmica nodosa.