Tactile transuterine cannulation for treatment of proximal tubal blocks using in vitro fertilization disposables

A total of 15% of married couples experience infertility. Of these, 30% have infertility secondary to tubal causes, and 15% of patients with tubal infertility have a proximal (uterotubal junction) obstruction. Evidence of unilateral or bilateral proximal uterotubal obstruction is found in 10%-20% of all hysterosalpingograms carried out for the evaluation of infertility, and 16%-40% of these apparent proximal obstructions are false positives. Antispasmodic agents, including glucagon, diazepam, isoxsuprine, terbutaline, and general anesthesia, have been used in conjunction with hysterosalpingography but are of little practical benefit. Even the use of laparoscopy may not determine whether the visualized obstruction comes from a temporary cause, such as cornual occlusion by amorphous material, or whether true anatomical occlusion exists. True occlusion, by amorphous material, flimsy adhesions, or a polyp, can only be successfully treated by various uterotubal cannulation methods. A cost-effective tactile tubal cannulation procedure under laparoscopic guidance simplifies the procedure while preventing inadvertent trauma to the fallopian tubes with the glide wire. This technical commentary will highlight the ease of the technical steps that comprise the procedure and the reproducibility of the technique by a short training curve.