Posted: Tue May 15, 2012 10:24 am
Post subject: Laproscopic/Hysteroscopic Tubal Cannulation - chromotubation
Bit of a mouthful
Basically it's what i'm having in September , they go in through your belly button with one camera (laproscopy) to check out the outside of your uterus and tubes and ovaries and down below into your uterus through your cervix with another (hysteroscopy)to check for problems there, and then try and guide a fine wire into your tube , sometimes with a balloon catheter as well to try and clear any blockages (thats the tubal cannulation bit ) and then finally pass dye through the tubes to see if it's clear (chromotubation )
Sometimes it's done just like an HSG through the cervix using the x-ray pics to guide the wire into the tube and that can be done under concious sedation rather than aneasthetic .
Basically i'm doing this post because while researching it myself online I've found very little info on it in the UK , most of the stuff comes from the US , and yet the NICE guidelines from 2004 state that it is a good procedure to try for women diagnosed with proximal end blockages (blockages near the womb) before going on to IVF
So it should be being used more as a lot of infertility these days especially secondary infertility is caused by tubal problems
Almost all the UK sites I've looked on I've seen woman after woman told that IVF is the only option with blocked tubes, and was even told that myself back in last May originally and then again last November ,and yet this is a relatively simple procedure with good success rates , so i'm putting this post on so if someone else googles the proceedure hopefully they will find this and realise that it is available on the NHS in the UK , and should be discussed as an option before IVF if they want to try it .
The proceedure has a 80-90% success rate at unblocking tubes from the studies done so far and has comparable pregnancy rates to IVF , without the risks of complications such as OHSS or multiple birth , although it does carry a slightly higher risk of ectopic pregnancy as any tubal surgery does .
But it also has the advantage of restoring fertility long term for a lot of women , their aren't many stats at the moment because not many docs do long term follow ups with HSG's to check tubes are still patent but just going from the longer term pregnancy stats for 2 to 5 yrs after this op it would seem like once the tubes are unblocked this way then for a lot of women they stay open maybe because there's no cutting and so no scarring
It is a popular procedure in the US, probably because health insurance will cover this but not IVF , so docs will try it first and I've read loads of success stories on US sites, so it frustrates me that it's not done more over here
It was only because I found out about it myself and pushed twice for another referral that i eventually got to the point of being given an op date for September If i had just accepted what the first doc told me last May (that there was nothing more they could do ) then I would never have got to this point now , i'm sure a lot of people do just accept that there's nothing more the NHS can do and end up paying for IVF , so i just wanted to put this post on to say :
It is available , not many surgeons in the UK do it but it is something you should be given the option of,
If a doc trys to fob you off, quote the NICE guidelines at him (it worked for me ) and insist on a referral to a hospital where this procedure is carried out so you can be assessed properly for suitability
I will update this post once I've actually had the procedure to say if it was successful , If anyones interested the surgeon who's doing my procedure is Dr Seif at St Mary's in Manchester I know there's a surgeon in scotland who does it on the NHS also and quite a few private clinics in London , but i had a real struggle trying to find any information on the NHS availability for this op and it was pure chance that i saw a doc for my last follow up who knew of this Dr Seif in manchester and offered to do the referral for me , but it is something that a gynae cons should be able to find out for you xx
Posted: Tue May 15, 2012 4:09 pm
Pen I've got a date of the 11th of September, was the earliest they had but i'm also on the cancellation list :)It is amazing what they can do and it's a technique they stole from an op to unblock heart ateries xx
Nutty I've watched a few on you tube (as you do ) and it does look interesting and also pretty simple , i think the only reason he does the laproscopy bit as well is to confirm if he dye goes through and so he can check there aren't any other problems , which is good because if there were any adhesions on the outside he can remove those too It's actually got a really good success rate with uterine end blockages because often they're just caused by a bit of debris, like a bit of womb lining or mucus and after watching the vids and seeing how small those openings are i can see why they can get blocked xx
Posted: Tue Jul 24, 2012 10:08 am
Post subject: LAP DYE HYSTEROSCOPY CANNULATION
I was glad to read your post.
I am also in a similar position to you and have been placed on the waiting list for LAPAROSCOPY AND DYE, HYSTEROSCOPY AND CANNULATION !!
I have been TTC for over a year..partner is younger than me, I have two kids from previous who are coming up to 16 n 17...
I thought at first it was me not ovulating right as I am 42, however I done the baseline tests avail on the NHS from the GP
Scan - Normal pelvic scan
Day 21 progesterone 42.1
and then thought oh yeah im fine, so we done an internet sperm test and that was fine...then i reaised oh its my TUBES..SO THEN WENT PRIVATE and got a HSG done..this showed both tubes were blocked one proximal one distal..then i went to the STI clinic to make sure I do not have any infections and to find out why my tubes were blocked as I had a coil in situ for about 10 years the tests were fine and then i had to literally FIGHT MY WAY to explain that i just want my tubes unblocked to try for a baby i can not afford IVF and it is not an option...so went to the gynae appt he also said IVF is your only option i said what about cannulation etc he said okay will try...and placed me on the waiting list I have a letter from the bynae copied to me to my GP whic lists all the risks like bowel perforation uterus perforation and that despite telling me the risks i wanted to go ahead...so am cheesed off about that..but those risks are minimal right ? sorry this post is a long one...i agree with you nat you are right there is little info inthe UK ABOUT THIS PROCEDURE...THEY AHAVE ALSO SAID IT MAY NOT BE A SUCCESS...BUT HEY....I WOULD RATHER TRY THAN GIVE UP...
Posted: Wed Jul 25, 2012 7:52 am
Yeah LHC they have to tell you about those risks just to cover themselves but the risks are very small as they use cameras to guide them
It is your right to have this op if you want it , especially if IVF is less likely to work but they do tend to say oh just have IVF, all very simple if you have time to wait and the NHS will pay but if you have to self fund then it's cruel
I was also told twice IVF was my only option and discovered this op for myself online, and as soon as I asked about it and pointed out that the NICE guidelines say it should be offered there was a big turnaround and I was given a referral for it
It's true it might not work but its better to try and fail than not try as you said at least then you know you've done all you can and the succes rates for actual unblocking that I found were around 80-90 % which are pretty good with a follow up pregnancy success of about 30-35% in the studies that did follow ups (which is better than the 16% success rate i was given for IVF )
I'm also 42 but had good test results, so FX this op gives us both a shot
My ops now been put back to the end of october which i'm a bit pee'd off about but whats a few more weeks after waiting 2yrs I suppose
FX you get a date for your op soon , where are you having it done ? xx
Posted: Wed Jul 25, 2012 8:32 am
Post subject: Re: lap dye hysteroscopy and cannulation..!!
Thanks for the reply
So we are in the same boat..
As soon as I realised it could be tubal, there was no tests according to my GP only a lap and dye which I would not be eligible for as it was for those wanting IVF and I did not meet the criteria...it was also only by chance that my GP was on leave and after going to a sexual health clinic the nurse said they should be able to investigate your tubes, and then there was literally an argument almost between the sexual health clinic and my GP who said I got it all wrong..anyway he was on leave and I went back to the GP to another GP in the practice and I said look my tubes are blocked, forget me wanting to get a freebie baby on the nhs i just SIMPLY WANT MY TUBES UNBLOCKED....and then that was it..so he done a referral to a Doctor at QEH Woolwich, now this Consultant was recommened by the Sexual Health Clinic but then on seeing him he said IVF blah blah blah and i just burst out crying...as the emotional issue is/was..that ive got two kids from previous but my new partner has not got kids and we want to have a baby...and if I am unable to do so I felt im cutting him short in the relationship but he said hey we have two kids already so do not worry...but of course who wouldnt love a baby of their own...so anyway the consultant said OKAY..I will try to help you, if its a success then I would be happy for you but due to your age etc...it may not be..so I said what about my tests arent they good...he said that well there is another test for egg health not avail on the nhs AN AMH test...i havent had it done yet also we need to re do the sperm test privately before i have this op...i had my appt just last week with the consultant he said 13 weeks waiting list..so need to chase and also offer them the fact that i can come in at short notice..lol..I keep meaning to loo k into taking some other supplements during this waiting period so that if and when they are unblocked successfully then I have increased my chances if you know what I mean...
Posted: Wed Jul 25, 2012 1:24 pm
Your GP was talking [*@!#%*] (excuse my french) I had a HSG and then 2 lap and dyes on the NHS before getting my referral for this procedure the lap and dye is just to check if your tubes are definately blocked and a lot of women on here have had them who weren't going for IVF , plus thats a gynae cons decision to make not a GP's
13 weeks waitng time sounds about average thats about what mine was , i had an app in May and was booked for early september, but then got a letter a couple of weeks ago saying that it was being put back to the end of october as the cons had decided he wanted a holiday right when my op was due so instead of putting everyone back two weeks they just shoved us to the back of the queue but what can you do
i've not had the AMH either my first cons said it was more of an indicator of how well you'd respond to IVF than anything and even if it was low you could still have a few yeasr left to conceive so I never bothered paying to get it done it's not even testing for egg health its a test for ovarian reserve to get a rough idea of if you're getting closer to the menopause the only way to check egg health is to look at them during IVF and see how well they hold up
I started making sure I always take my supplements now as it takes 85 days for an egg to fully mature so its good to start early , i just got asdas own brand conception vits after reading the labels as they have the same stuff as the more expensive brands and I got something called Maca for me and the OH as its a good source of zinc and selenium which are good for eggs and sperm, the conception vits have folic acid in already so thats covered too
The cannulation has good results though with proximal blockages so you're in with a good chance and even if they can only do one tube it doesn't affect your chances much as either tube can pick up the egg from either ovary (which i was very pleased to hear as i only have one tube ) So FX we could both have a BFP before the end of the year xx
Posted: Sun Jul 29, 2012 8:37 am
Post subject: Lap dye hysteroscopy n cannulation
Hi nat thanks for the useful info I have my pre op this coming thurs where the just do the simple checks before the op I rang them to find out when the op is and they said it could still be a couple of months away .. So anyway did not do the amh test thanks for letting me know what u were told about it .. I was taking Macca n the conception vitamin need to restart ....I just hope they can clear the tubes and all goes well ...the tubes are so delicate and at the same time complex little things this is on my mind most of the time ..my tubes..lol I took some time out tried not to think about it but now again on my mission I hope all goes well for you and you get on the cancelled op list ...you are doing all the right things from my research thanks to google so hopefully we could be pregnant this year...since u have had two lap dyes when can one resume normal antics again how well did u recover ? time off work etc. Will enjoy that thanks.