Tubal Recanalization, Hysteroscopy & IUI:
IVF is not always the solution to have a baby!
TUBAL RECANALIZATION
Are your tubes blocked making it hard to get pregnant? IVF is not always the right option… FALLOPIAN TUBE RECANALIZATION is just the thing for you!
Blocked fallopian tubes is a major cause of infertility for many women, especially those who had history of STDs, or endometriosis, or previous pelvic surgery. Recanalization is the medical term for “reopening.” Fallopian tube recanalization can help remove mucus or debris that is blocking one or both fallopian tubes. During the 30-minute procedure, a tiny catheter is passed into the cervix by hysteroscopy to the Fallopian tube and the blockage is cleared.
When the tubal blockage is close to the uterus, its technical success rate is up to 90% and is extremely effective for treating tubal obstruction. This would allow for NATURAL conception and for conceiving with IUI, without the need for IVF.
We can help patients anywhere in the world. Indeed, up to 60% of RFC patients are from outside the NY area. RFC’s success rates of 59% surpasses national averages of 43% with tailored treatments for every patients especially those with low AMH, high FSH, PCOS, or those who are poor responders to conventional IVF. Since 2020, RFC has been reporting highest success rates yearly in the country with a 68% success rate for IVF with PGT and 69% for women under 35. Emphasis on affordability and personalized care is our main mission.
Dr Merhi has helped the oldest woman in the USA get pregnant by IVF using her own eggs at age 51. RFC has helped the highest number of women in their early 50’s and late 40’s get pregnant using their own eggs by IVF.
DETAILED HYSTEROSCOPY
At RFC, 1 in 4 women get pregnant naturally after a detailed hysteroscopy (sometimes referred to as diagnostic hysteroscopy with possible operative intervention) which is a gynecologic procedure used to closely examine and fix the inside of the uterus using a hysteroscope, a thin, lighted telescope-like instrument inserted through the vagina and cervix.
Here’s a breakdown of what makes it “detailed” and what to expect:
Purpose of a Detailed Hysteroscopy
It allows the physician to directly visualize and evaluate:
- The uterine cavity
- The endometrium (lining of the uterus)
- The tubal ostia (where the fallopian tubes open into the uterus)
It is typically used to investigate or treat:
- Suspected implantation issues
- Suspected intrauterine adhesions/scarring (Asherman’s syndrome)
- Recurrent miscarriages
- Abnormal uterine bleeding
- Suspected uterine anomalies (e.g., septum, adhesions)
- Polyps or fibroids
What Makes It “Detailed”?
A detailed hysteroscopy:
- Includes high-resolution imaging to assess subtle abnormalities.
- Involve saline infusion sonography (SIS) beforehand or in conjunction.
- Use operative tools to treat issues during the same procedure (e.g., remove polyps, lyse adhesions).
- Be scheduled in a specialized setting such as an outpatient surgical center for better access and control.
Procedure Steps
- Preparation: Done under light sedation.
- Dilation: The cervix may be gently dilated to allow insertion of the hysteroscope.
- Visualization: Saline is used to distend the uterus for better visibility.
- Examination/Treatment: RFC doctor inspects the cavity, documents findings, and treat abnormalities immediately.
- Recovery: Typically minimal downtime, though cramping or light bleeding is common for 1–2 days.
Duration
- Diagnostic hysteroscopy: ~10–15 minutes
- Detailed or operative hysteroscopy: ~30 minutes, depending on intervention
Why IUI is better than sex in order to conceive?
IUI provides 4 advantage over sex alone:
- Best sperm! In IUI, the lab will process the sperm (called sperm washing) in order to get the best quality sperm at a high concentration since only a small percentage of the sperm is viable.
- Shorter distance for the sperm to reach the egg! IUI shortens the distance the sperm needs to travel and increasing the chance of sperm reaching the egg to achieve fertilization.
- Better timing! We will monitor your ovulation closely in order to make sure that the sperm and the egg meet at the right time
- Avoid the vagina! A lot of sperm gets killed in the vagina due to the acidity of the vagina. During the IUI process, the sperm is not exposed to the vaginal acidity because they are deposited immediately inside the uterus.
You are a candidate for IUI if:
- You have at least one open fallopian tube
- You are using donor sperm (for example: Lesbian couple)
- You have irregular period/ovulation such as in PCOS
- You have unexplained infertility (infertility in which the exact cause cannot be identified)
- Sperm has mild abnormalities
- You have endometriosis (a painful inflammatory condition of the female pelvis)
- Vaginal/Cervical factor infertility (related to prior surgery such as LEEP)
MEDICAL REFERENCES:
- Mody P. Recanalization of Proximal Fallopian Tube Obstruction in the Treatment of Infertility.Semin Intervent Radiol. 2023 Aug 10;40(4):379-383.
- Thompson KA. Transcervical fallopian tube catheterization and recanalization for proximaltubal obstruction.Fertil Steril. 1994 Feb;61(2):243-7
- Tanaka Y. Renaissance of surgical recanalization for proximal fallopian tubal occlusion: falloposcopic tuboplasty as a promising therapeutic option in tubal infertility.J Minim Invasive Gynecol. 2011 Sep-Oct;18(5):651-9