Tubal Infertility: A Review for Interventional Radiologists

Abstract Proximal fallopian tube obstruction (pFTO) is a common and potentially reversible cause of female subfertility. Image-guided techniques have established interventional radiology as a central discipline in the diagnosis and treatment of this condition. This review summarizes the pathophysiology, imaging evaluation, and management of pFTO, with a primary focus on fluoroscopy-guided transcervical fallopian tube recanalization (FTR). Normal tubal anatomy, mechanisms of proximal obstruction, and the diagnostic and therapeutic roles of hysterosalpingography are reviewed. Technical aspects of FTR, including patient selection, procedural technique, periprocedural care, and follow-up, are described. Published outcomes demonstrate technical success rates exceeding 90% with favorable pregnancy outcomes in appropriately selected patients and low complication rates. Given its safety profile, cost-effectiveness, and ability to immediately restore tubal patency, fluoroscopic FTR represents an effective first-line, minimally invasive treatment for women with isolated pFTO and an important application of image-guided therapy in infertility care.