Fallopian tube recanalization (FTR) is a non-surgical procedure performed to treat obstruction of the fallopian tubes, which are an essential part of a woman's reproductive system.

The American Society for Reproductive Medicine has recommended that patients who have proximal tubal obstruction undergo this procedure prior to any other more invasive procedures.

The fallopian tubes are important for female fertility. They are the passageway for the ova to travel from the ovaries to the uterus.

A common cause of female infertility is obstruction of the fallopian tubes.

This may be a result of accumulation of debris such as mucus in the tubes, or due to scarring (fibrosis) or injury from previous surgery or from previous serious pelvic infections.

Fallopian tube recanalization is a non-surgical procedure that is performed by interventional radiologists to treat blockage of the fallopian tubes.

These are the general steps during the procedure;

1. A speculum is placed into the vagina and a small plastic tube (catheter) is passed through the cervix into the uterus.
   
2. Liquid contrast is injected through the catheter.
   
3. The uterine cavity is examined on a nearby monitor using X-ray (fluoroscopy).
   
4. A hysterosalpingogram or HSG is obtained ("uterus-and-fallopian-tube-picture”).
   
5. It is determined if there is a blockage and if it is located in one or both fallopian tubes.
   
6. A micro catheter (smaller catheter) is inserted through the initial catheter and then into the fallopian tube to clear the blockage.
   

The procedure is successful in more than 90% of cases, resulting in the unblocking of at least one fallopian tube and restoration of normal function.

The procedure is performed using sterile technique to avoid the possibility of introducing infection. The procedure usually takes between 30 to 60 minutes, most of which is spent in getting the patient comfortable, readying the equipment, and cleaning the skin. 

The actual time spent in evaluating and unblocking the tubes is usually only a matter of minutes and you will be able to leave about a half hour after your procedure is completed.

You must be accompanied by an adult who can take you home afterward.

The doctors will explain to you and your companion the results and a letter will be sent to your doctor as well.

Two days before your procedure, your gynecologist will prescribe an antibiotic, which you will continue up to and after your procedure for approximately two more days.
FTR is sometimes uncomfortable, so an intravenous line is placed prior to the procedure. Short-acting medications will be given for relaxation and pain relief. You will be instructed to not eat anything after midnight the night before.

You will also be asked to take a pain medication such as Ibuprofen 400 mg the night before and the morning of your procedure.

Usually, both fallopian tubes can be unblocked. On average, about a quarter of couples will conceive, most within a cycle or two. The FTR procedure was timed so that there was no risk of being fertile at the time of your procedure. You may begin trying to get pregnant again once the spotting has stopped, and don't have to wait an extra cycle in between.

Douching is not advisable in general, but particularly after the FTR because the cervix may be slightly open for a day or so.

Successful FTR and pregnancy are lower when severe scarring is present from prior surgery or bad infections, such as PID (Pelvic Inflammatory Disease).

FTR unblocks the tubes, but does not treat or reverse the process that caused them to obstruct in the first place. For this reason, approximately 30% of patients may re-obstruct their tubes again within 6 months.

You may wish to consult your doctor if you have not gotten pregnant after 6 months and he or she is thinking about enhancing your fertility, such as giving you injections to stimulate your ovaries. It is advisable in that case to make sure that your tubes are still open.

An interventional radiologist can perform an HSG and safely repeat the FTR if blockage is again found.

Most women will have a little spotting for a day or two afterward.

You will be given you a pad in recovery and you may wish to have some pads at home in case of spotting.

There should be no lingering pain or other unpleasant sensation. If you experience pain, cramps, fever, or vaginal discharge, please contact your gynecologist immediately.

The contraindications to the fallopian tube recanalization procedure include: active bleeding, active pelvic infection, recent surgery and current pregnancy.