Fluoroscopically Guided Cervical Dilatation in Patients with Infertility

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery

Background:

• Uterine cervical stenosis, from congenital or acquired causes, significantly impacts female fertility.
• Narrowed cervical canals impede diagnostic procedures (endometrial biopsy, hysterosalpingography) and fertility treatments (in vitro fertilization and embryo transfer [IVF-ET], insemination).
• Traditional cervical dilatation methods can be traumatic, risking uterine perforation or false passage creation.

Purpose of the Study:

• To evaluate the efficacy and safety of fluoroscopically guided angioplasty balloon dilatation for cervical stenosis.
• To assess the feasibility of this technique for improving access to the uterine lumen in infertile patients.

Main Methods:

• Fifteen patients with cervical stenosis preventing uterine access underwent cervical dilatation using an angioplasty balloon under fluoroscopic guidance.
• Simultaneous fallopian tube recanalization was performed in five patients.

Main Results:

• The procedure was technically successful in all patients, allowing access to the uterine lumen.
• Only one patient experienced mild, self-resolving vaginal bleeding; no pain requiring narcotics or infections were reported.
• Five women conceived post-procedure (one after IVF-ET, two with intrauterine insemination, two spontaneously).
• Cervical cannulation was easily achieved in non-pregnant patients after the procedure.

Conclusions:

• Fluoroscopically guided balloon dilatation is a safe and effective method for treating cervical stenosis.
• This technique expands treatment options for infertile women with cervical stenosis, facilitating subsequent fertility procedures.
• The procedure demonstrates a favorable safety profile with minimal complications.