A 30-year-old woman with primary infertility for 2 years has regular 28-day cycles and normal hormonal profile. Hysterosalpingography shows bilateral proximal tubal block. The most appropriate next step in management is:
- A Laparoscopy with chromopertubation
- B Hysteroscopic cannulation with selective salpingography ✓
- C In vitro fertilization
- D Tubal microsurgery
Correct answer: B. Hysteroscopic cannulation with selective salpingography
Explanation
Proximal tubal occlusion is best managed by hysteroscopic cannulation with selective salpingography, which is both diagnostic and therapeutic. It is less invasive than laparoscopy and has good success rates for proximal block. IVF is reserved for failed recanalization or distal block. Tubal microsurgery is largely superseded by IVF for distal disease.
Reference: Te Linde's Operative Gynecology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.