Radiology, Vol 200, 497-503, Copyright © 1996 by Radiological Society of North America
Transvaginal uterine cervical dilation with fluoroscopic guidance: preliminary results in patients with infertility
KW Dickey, TG Zreik, HC Hsia, DJ Eschelman, DL Keefe, DL Olive, JS Pollak, M Rosenblatt and MG Glickman
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06510, USA.
PURPOSE: To assess efficacy of uterine cervical dilation performed with
fluoroscopic guidance to treat patients with infertility who have cervical
stenosis, false channels within the endocervical canal, or both. MATERIALS
AND METHODS: Fifteen patients in whom infertility was diagnosed were
referred because the uterine lumen could not be accessed. Three of the
patients had endometriosis. With fluoroscopic guidance, the cervix was
cannulated and the endocervical canal was dilated with an angioplasty
balloon or with dilators. Five patients underwent simultaneous fallopian
tube recanalization. Five of 15 patients who underwent dilation
subsequently underwent in vitro fertilization for embryo transfer (IVF-ET)
or intrauterine insemination. RESULTS: Four patients became pregnant. Of
those four, one underwent IVF-ET and one underwent intrauterine
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 cannulated up to 7
months after dilation. CONCLUSION: Dilation of the uterine 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.
