TRANSVAGINAL UTERINE CERVICAL-DILATION WITH FLUOROSCOPIC GUIDANCE - PRELIMINARY-RESULTS IN PATIENTS WITH INFERTILITY

PURPOSE: To assess efficacy of uterine cervical dilation performed wit h fluoroscopic guidance to treat patients with infertility who have ce rvical stenosis, false channels within the endocervical canal, or both . MATERIALS AND METHODS: Fifteen patients in whom infertility was diag nosed were referred because the uterine lumen could not be accessed. T hree of the patients had endometriosis. With fluoroscopic guidance, th e cervix was cannulated and the endocervical canal was dilated with an angioplasty balloon or with dilators. Five patients underwent simulta neous fallopian tube recanalization. Five of 15 patients who underwent dilation subsequently underwent in vitro fertilization for embryo tra nsfer (IVF-ET) or intrauterine insemination. RESULTS: Four patients be came pregnant. Of those four, one underwent IVF-ET and one underwent i ntrauterine insemination. Two patients became pregnant spontaneously. In the five patients who underwent IVF-ET or intrauterine insemination and in the remaining eight patients, the cervix could be easily cannu lated up to 7 months after dilation. CONCLUSION: Dilation of the uteri ne cervix may provide options for treatment in selected patients with infertility. The effect of dilation on patients with other sequelae of cervical obstruction such as endometriosis remains uncertain.