Infertility Treatment Technology-Field Report from the Front Lines

FT (Fallopian Angioplasty Under Fiberscope)


It is said that 30% of infertility causes are due to fallopian tubal factors. Fallopian tubes have closures (adhesion), and this is one of the causes of fertility failure. Today we have met with Dr. Yoshihiro Tada, who is a specialist with Fallopian Angioplasty Under Fiberscope, which removes closures (adhesions) of the fallopian tubes.


Dr. Yoshihiro Tada

This time we received an answer about "Plastic surgery of Fallopian tubes" from Dr. Yoshihiro Tada.

Graduate from Kyoto Prefectural Medical University, after working at the National Maizuru Hospital, Kyoto Prefectural Yosanoumi Hospital, and Matsushita Memorial Hospital he then joined Oak Medical Group at Sumiyoshi.
He has extensive experience in hysteroscope surgery. Presently, he is in charge of a wide range of practices from Urology, testicular extraction of sperm (TESE) to hormone treatment, specializing in male infertility.


Please tell us about FT (Fallopian Angioplasty Under Fiberscope).

This is a procedure that applies to those who have fallopian closures (adhesions), and will widen the constricted and closed portions of the fallopian tubes. Since the fallopian tubes is where fertilization takes place, if they are closed (or have adhesions), then fertilization cannot be achieved. In addition, it may lead to repeated ectopic pregnancy, or in worse case even death.
There are two Fallopian tubes, and if one is obstructed it is a huge misconception to think that since the other one is fine that there is no problem. It has been generally considered that ovulation occurs alternately between the two ovaries, but it has also been found that the right ovary may ovulate in succession, and so we can say that the same is true for the left ovary respectively. In accordance with this, when ovulation occurs on the side where the Fallopian tubes are obstructed or closed, then it will not lead to natural fertilization.
Also, even if an oocyte makes it through one side, there are still some cases where the state of fallopian tube is not good. The fallopian tubes have a series of small folds that will carry the oocyte by the movement of the folds. If the function is weakened, the oocyte will not be carried well, and fertilization will be more difficult.
The cause of obstruction spans from various conditions, such as endometriosis and chlamydia.



What kind of surgery is it?

This is an internal observation procedure using the fiberscope. About a 0.5mm fiberscope is contained within about a 1mm catheter, which is passed through the vagina and by confirming with the fiberscope it will be inserted into the fallopian tubes. The closed or constricted portions of the fallopian tubes will be widened by a balloon from the entrance of the fallopian tubes.
Since there will be pain associated with this procedure we will be using anesthesia during the operation. It will take around 10 minutes to do one side, a very simple 1-day procedure not requiring any clinical stay and the cost is about \180,000 which is covered by insurance. After the surgery, and for 2 years the rate of pregnancy will be 30.3%, but please consider that there is data that says 20% of those having this procedure done will have a reoccurrence.





What would be the special features and strengths of the FT at Oak Clinic?
Also, are there other methods available if the FT doesn't pass through the fallopian tubes?

We will use the hysteroscope for uterine myomas, and a combination of laparoscope, hysteroscope and fiberscope for deep closures (adhesions) or malformations.
When it doesn’t go through by fiberscope, there is a high possibility of having a closure (adhesion) in the fimbria (the tip end of the fallopian tube that is shaped like a fan) of the fallopian tubes. Therefore, as the next step, there is the method of making an opening to the fimbria. However, these procedures are quite expensive, if surgery is not done until this point, and if it is a condition where it still does not pass through the fallopian tubes, then we recommend to proceed to IVF.



What kind of person should have FT?

FT is for those who are young, having no male-side fertility problems, desiring a natural pregnancy or artificial insemination. For those who are older, have male-side fertility problems, it is thought of as good to take the plunge and go on to IVF, as opposed to this procedure.
Additionally, just because it passed through the fallopian tubes by doing FT, doesn’t mean you will get pregnant. At our clinic, after FT, for those patients who don’t achieve pregnancy after doing timing and artificial insemination 3 times we recommend them to have IVF.



From what age is it okay to take the plunge into IVF?

In the medical world it is said to be between 35 and 38 years of age, but I usually say 35 years old. If you are 35 and don’t have pregnancies by timing or artificial insemination, then you should proceed to IVF. This is data has been backed very clearly by the Japan Society of Obstetrics and Gynecology, but there is a obvious difference in the pregnancy rate after 35 years old.
I don’t want you to misunderstand because there are those who are pregnant at 38 and 40, but these are individuals with a high ability to get pregnant. On average, the pregnancy rate decreases from 35. Please carefully think about the average time leading to pregnancy, the cost involved with treatments alongside what personalized treatments work best for you.



Oak Medical Group has been from the time we opened, supporting the many issues of women's health, building performance and trust, and not only here in Osaka, but centering in Kansai we are receiving patients from across Japan.
Especially with our infertility treatment, we are widely covering the various tests to IVF/ICSI's Advanced Reproductive Technologies.  Depending on the cause of the infertility, we are handling the treatment of each patient one by one.  If you have some concerns, please don't hesitate to consult with us.